Individual
YEVGENY EUGENE MIRONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
279 E KENNEDY ST, SPARTANBURG, SC 29302-1912
(864) 583-0053
(864) 583-0390
Mailing address
PO BOX 6130, SPARTANBURG, SC 29304-6130
(864) 583-0053
(864) 583-0390
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
184375
SC
208VP0014X
Interventional Pain Medicine Physician
200200419
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013KE
BC
NC
01
—
571049338
BC
SC
05
—
89013KE
—
NC
05
—
GP1456
—
SC
05
—
GP2967
—
SC
Enumeration date
07/26/2006
Last updated
01/29/2021
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