Individual
JOHN THOMAS MIURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104
(267) 588-9179
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD467947
PA
Other
Enumeration date
04/01/2010
Last updated
09/18/2019
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