Individual
BRYAN KEITH MIKSANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
950 W WOOSTER ST, BOWLING GREEN, OH 43402-2603
(419) 354-9810
Mailing address
2437 TIFFANY VILLAGE BLVD, SYLVANIA, OH 43560-9465
(419) 829-2544
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35.061812
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0900752
—
OH
Enumeration date
02/08/2006
Last updated
02/26/2008
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