Individual
DMITRY MIRONOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24 STEVENS ST, NORWALK, CT 06850-3852
(203) 852-2276
(203) 852-2527
Mailing address
804 SCOTT NIXON MEMORIAL DR, AUGUSTA, GA 30907-2464
(706) 650-0705
(706) 650-1034
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
037028
CT
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
037028
CT
Other
Enumeration date
05/24/2005
Last updated
11/07/2007
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