Individual
DR. BRUCE ROBERT MIRVIS
Active
Individual
DR. BRUCE ROBERT MIRVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2018042193
MO
208000000X
Pediatrics Physician
Primary
35.039260
OH
208000000X
Pediatrics Physician
4301116689
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0345086
—
OH
Enumeration date
02/02/2006
Last updated
02/09/2023
Update your record
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