Individual
DR. ERNEST C MIRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8550 BROADWAY, SUITE C, MERRILLVILLE, IN 46410-7032
(219) 769-3550
(219) 769-8604
Mailing address
8550 BROADWAY, STE C, MERRILLVILLE, IN 46410-7193
(219) 769-3550
(219) 769-8604
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01018811
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083040
ANTHEM
IN
05
—
100377790
—
IN
01
—
110085078
RAILROAD MEDICARE
IN
01
—
192820H
MEDICARE PART B
IN
01
—
2210201
MEDICARE
IN
01
—
385970A
MEDICARE PART B
IN
Enumeration date
09/23/2005
Last updated
11/25/2019
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