Individual
RAEMA MIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
141 ROUTE 70 E STE E, MARLTON, NJ 08053
(856) 985-7373
(856) 985-9611
Mailing address
301 LIPPINCOTT DR STE 120, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0346
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA10171700
NJ
207Q00000X
Family Medicine Physician
C7-0005377
DE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2013
Last updated
10/16/2020
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