Individual
BRUCE E MIRBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
LAHEY CLINIC, 41 MALL ROAD, BURLINGTON, MA 01805-0001
(781) 744-8000
(781) 744-5261
Mailing address
LAHEY CLINIC, 41 MALL ROAD, BURLINGTON, MA 01805-0001
(781) 744-8000
(781) 744-5261
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
40365
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110066004A
—
MA
Enumeration date
09/16/2006
Last updated
06/18/2012
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