Individual
DR. JOHN MIRRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 E 87TH AVE STE 420, MERRILLVILLE, IN 46410-7335
(219) 758-5008
(219) 758-5009
Mailing address
7895 GRAND BLVD, HOBART, IN 46342-6665
(219) 947-1910
(219) 947-3117
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01024382A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000085025
ANTHEM BC/BS
IN
05
—
100187310A
—
IN
01
—
110044492
RAILROAD MEDICARE
IN
01
—
9115389
ANTHEM BC/BS
IL
Enumeration date
06/02/2005
Last updated
03/15/2023
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