Individual
DR. SIDNEY S. MIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7905 ELLENHAM AVE, BALTIMORE, MD 21204-3523
(410) 583-1566
Mailing address
7905 ELLENHAM AVE, BALTIMORE, MD 21204-3523
(410) 583-1566
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D0019416
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D0019416
MARYLAND MEDICAL LICENSE NUMBER
MD
Enumeration date
10/12/2012
Last updated
10/12/2012
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