Individual
DR. SERGEY MIRAKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 BLACKHORSE HILL ROAD, BLDG 39, ROOMB06G, COATESVILLE, PA 19320
(610) 384-7711
Mailing address
1400 BLACKHORSE HILL ROAD, BLDG 39, ROOMB06G, COATESVILLE, PA 19320
(610) 384-7711
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
10276247-1205
UT
2084P0800X
Psychiatry Physician
MD460854
PA
2084P0802X
Addiction Psychiatry Physician
MD460854
PA
2084P0802X
Addiction Psychiatry Physician
Primary
ME138827
FL
390200000X
Student in an Organized Health Care Education/Training Program
MT204799
PA
Other
Enumeration date
12/29/2011
Last updated
07/21/2022
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