Individual
ALIREZA MIRMIRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8303 DODGE ST, SUITE # LL6, OMAHA, NE 68114-4108
(402) 354-4104
(402) 354-8761
Mailing address
PO BOX 10190, VIRGINIA BEACH, VA 23450-0190
(800) 477-5240
(757) 463-6572
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
25152
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025044300
—
NE
05
—
10025775900
—
NE
05
—
1801930441
—
IA
Enumeration date
02/16/2007
Last updated
12/17/2013
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