Organization
POLARIS PEDIATRICS INC
Active
Other names
Bruce Mirvis, MD
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE ROBERT MIRVIS M.D. (OWNER)
(614) 437-5600
Entity
Organization
Contact information
Practice address
8947 ANTARES AVENUE, COLUMBUS, OH 43240-2012
(614) 437-5600
(614) 985-1499
Mailing address
8947 ANTARES AVENUE, COLUMBUS, OH 43240-2012
(614) 437-5600
(614) 985-1499
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35039260
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0345086
—
OH
Enumeration date
03/28/2011
Last updated
07/07/2011
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