Individual
ROSS MIRMAN
Active
Individual
ROSS MIRMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01078491A
IN
207L00000X
Anesthesiology Physician
Primary
DR.0059586
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001289189
ANTHEM PTAN
IN
05
—
300028154
—
IN
Enumeration date
06/10/2014
Last updated
12/04/2024
Update your record
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