Individual
DR. MICHAEL AV MIRZAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 E INTERSTATE AVE STE B, BISMARCK, ND 58503-1566
(701) 323-6543
(701) 323-5492
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
12502
ND
2084P0800X
Psychiatry Physician
12616
HI
2084P0800X
Psychiatry Physician
K-6777
TX
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
12502
ND
2084P0804X
Child & Adolescent Psychiatry Physician
12616
HI
2084P0804X
Child & Adolescent Psychiatry Physician
K-6777
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452924
—
ND
Enumeration date
02/15/2007
Last updated
08/21/2020
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