Organization
SIERRA VISTA PATHOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAX S MIROT MD (SOLE OWNER)
(520) 459-1984
Entity
Organization
Contact information
Practice address
5700 E HIGHWAY 90, SIERRA VISTA, AZ 85635-9110
(520) 335-1800
(520) 335-2743
Mailing address
4266 INDUSTRY DR, SUITE 1, SIERRA VISTA, AZ 85635-2203
(520) 335-1800
(520) 335-2743
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
904866
—
AZ
Enumeration date
05/31/2013
Last updated
05/08/2015
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