Individual
TAHIR USMAN MIR
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7 S 5TH ST, INDIANA, PA 15701-2702
(724) 463-1410
(724) 463-1410
Mailing address
7 S 5TH ST, INDIANA, PA 15701-2702
(724) 463-1410
(724) 463-1410
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD037173L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007488170001
—
PA
01
—
1005099
GATEWAY
—
01
—
P00038373
CHAMPUS
—
01
—
P002008
GATEWAY
—
Enumeration date
07/19/2005
Last updated
07/08/2007
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