Individual
SHIRLEY A MIRISCIOTTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.002363
OH
363A00000X
Physician Assistant
Primary
50.002363RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0147626
—
OH
Enumeration date
04/16/2007
Last updated
08/25/2020
Update your record
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