Individual
MRS. MIRANDA L GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2992
SC
363AS0400X
Surgical Physician Assistant
50.002889
OH
363AS0400X
Surgical Physician Assistant
6038
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000613877
ANTHEM
—
Enumeration date
04/09/2009
Last updated
08/06/2018
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