Individual
KIRAN C TAMIRISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 NAVARRE AVE, OREGON, OH 43616-3207
(419) 696-7646
Mailing address
2600 NAVARRE AVE, PAIN CLINIC, OREGON, OH 43616-3207
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
35045601
OH
208VP0000X
Pain Medicine Physician
13332
WI
208VP0014X
Interventional Pain Medicine Physician
Primary
35045601
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000185388
BCBS
OH
05
—
0440866
—
OH
05
—
4272949-10
—
MI
Enumeration date
06/09/2006
Last updated
06/12/2025
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