Individual
DR. KENNETH R MIRKIN
Active
Individual
DR. KENNETH R MIRKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
0101036056
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100010309
RAILROAD MEDICARE
VA
01
—
178732
ANTHEM BCBS
—
01
—
187598
ANTHEM BCBS
—
01
—
231620
ANTHEM BCBS
—
01
—
336682
ANTHEM BCBS
—
01
—
341902
ANTHEM BCBS
—
05
—
6096026
—
VA
01
—
740013
ANTHEM BCBS
—
01
—
79160004
CAREFIRST BCBS
—
Enumeration date
01/31/2006
Last updated
01/21/2025
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