Individual
DAVID RANDALL MIRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2950 S MARYLAND PKWY, LAS VEGAS, NV 89109-2204
(702) 732-6000
(702) 243-7531
Mailing address
PO BOX 36900, LAS VEGAS, NV 89133-6900
(702) 732-6000
(702) 243-7531
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
6299
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200262805
—
NV
Enumeration date
07/26/2005
Last updated
03/18/2011
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