Individual
MIRNES MEHIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2018 E. WAGONER RD., PHOENIX, AZ 85022
(480) 720-4591
(602) 788-2246
Mailing address
2018 E. WAGONER RD., PHOENIX, AZ 85022
(480) 720-4591
(602) 788-2246
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL7900H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310400000X
AHCCCS
AZ
Enumeration date
02/07/2011
Last updated
02/07/2011
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