Individual
ANDREY MIRONENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 PORT ARTHUR RD, LADYSMITH, WI 54848-1137
(715) 532-2300
Mailing address
1200 PORT ARTHUR RD, LADYSMITH, WI 54848-1137
(715) 532-2300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
76887-20
WI
Other
Enumeration date
06/29/2019
Last updated
02/13/2024
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