Individual
MISO GOSTIMIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
840 WALNUT ST STE 930, PHILADELPHIA, PA 19107-5599
(215) 928-3130
Mailing address
840 WALNUT ST STE 930, PHILADELPHIA, PA 19107-5109
(215) 928-3130
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD476883
PA
207WX0109X
Neuro-ophthalmology Physician
MD476883
PA
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
MD476883
PA
Other
Enumeration date
09/15/2022
Last updated
09/15/2022
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