Individual
DR. HARVEY LEE MIRLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4700 MEMORIAL DR, STE. 340, BELLEVILLE, IL 62226-5373
(618) 235-7065
(618) 235-9020
Mailing address
4700 MEMORIAL DR, STE. 340, BELLEVILLE, IL 62226-5373
(618) 234-9884
(618) 235-9020
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
036085921
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447203971
—
IL
01
—
6394100002
MEDICARE DME
IL
Enumeration date
05/18/2006
Last updated
02/11/2021
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