Individual
MIRIAM E. PEARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000809
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01942101
CAPITAL BLUE SHIELD
—
01
—
542780
AETNA
—
01
—
584021
HIGHMARK BLUE SHIELD
—
Enumeration date
06/28/2006
Last updated
09/18/2012
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