Individual
DR. BENJAMIN JOHN MIRIOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 HOSPITAL DR SW STE 400, HUNTSVILLE, AL 35801-3495
(256) 705-4224
Mailing address
PO BOX 18428, HUNTSVILLE, AL 35804-8428
(256) 705-4224
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
24979
NE
207RH0003X
Hematology & Oncology Physician
2011-00444
NC
207RH0003X
Hematology & Oncology Physician
Primary
42932
AL
207RH0003X
Hematology & Oncology Physician
MD160868
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427234277
—
NC
05
—
275147
—
AL
05
—
500661059
—
OR
01
—
512-65052
BCBS AL
AL
01
—
512-65053
BCBS AL
AL
01
—
P01224287
MEDICARE RAILROAD
OR
Enumeration date
01/10/2008
Last updated
01/27/2023
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