Individual
JOSEL V MIJARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1116 MILLIS AVE, BOONVILLE, IN 47601-2226
(812) 897-7383
Mailing address
1116 MILLIS AVE STE 101, BOONVILLE, IN 47601-2226
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01047282
IN
207R00000X
Internal Medicine Physician
Primary
01047282A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200138590
—
IN
Enumeration date
06/01/2005
Last updated
07/26/2022
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