Individual
SEID ALI AKBAR MIRMIRAN-YAZDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 VERDAE BLVD, SUITE A, GREENVILLE, SC 29607-4032
(864) 242-4683
(864) 240-8104
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
17880
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100014552
RR MEDICARE
SC
05
—
178809
—
SC
Enumeration date
12/09/2005
Last updated
02/29/2016
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