Individual
DR. JOSEPH MIRRO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 N PARK ST, WEST MICHIGAN CANCER CENTER, KALAMAZOO, MI 49007-3731
(269) 910-6555
(269) 384-8610
Mailing address
200 N PARK ST, WEST MICHIGAN CANCER CENTER, KALAMAZOO, MI 49007-3731
(269) 910-6555
(269) 384-8610
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
13553
TN
2080P0207X
Pediatric Hematology & Oncology Physician
4301100173
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118886
—
MS
05
—
009914380
—
AL
05
—
0528836
—
IA
05
—
060495101
—
TX
05
—
100025910A
—
OK
05
—
100249681-00
—
NE
05
—
1135121 00
—
WY
05
—
133070001
—
AR
05
—
1427051200
—
MI
01
—
1447261730
BCBS - WMCC
MI
05
—
1534722
—
LA
05
—
200179770A
—
IN
05
—
209684901
—
MO
05
—
3821400
—
TN
05
—
422400000
—
ME
05
—
64712789
—
KY
05
—
Q13553
—
SC
Enumeration date
05/24/2005
Last updated
05/19/2014
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