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Individual

DR. JONATHAN A MIHNOVETS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4500 13TH STREET, GULFPORT, MS 39501
(228) 867-4396
(228) 867-5354
Mailing address
PO BOX 1810, GULFPORT, MS 39502
(228) 575-1194
(228) 575-2917

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29920
MS
208M00000X
Hospitalist Physician
29920
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1578806873
VA
Enumeration date
04/04/2013
Last updated
09/28/2023
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