Individual
SHAPOUR STEVE MIRMANESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12000 LINCOLN DRIVE WEST, SUITE 405, MARLTON, NJ 08053
(856) 985-0203
(856) 985-0010
Mailing address
5120 NEW HAMPSHIRE AVENUE, SWEETWATER, NJ 08037
(856) 985-0203
(856) 985-0010
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
25MA07725100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0033189
—
NJ
Enumeration date
07/11/2006
Last updated
07/08/2007
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