Individual
JOSEPH MIRABITUR III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP-BC
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-4436
Mailing address
14637 GARY LN, LIVONIA, MI 48154-5150
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704216623
MI
Other
Enumeration date
03/02/2012
Last updated
03/02/2012
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