Organization · NPI-2

Abdul B Mir MD PA

Internal Medicine · Crestview, FL

NPI number1255660775
StatusActive
Last updated in NPPESDec 11, 2009

Details

NPI
1255660775
Entity type
Organization (NPI-2)
Legal business name
Abdul B Mir MD PA
Organization subpart
No
Enumeration date
Dec 11, 2009
Last updated
Dec 11, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineME0032883FLYes

Practice location

131 E Redstone Ave
Suite 101
Crestview, FL 32539-5326

Phone 850-682-5174 · Fax 850-689-3653

Mailing address

131 E Redstone Ave
Suite 101
Crestview, FL 32539-5326

Phone 850-682-5174 · Fax 850-689-3653

Authorized official

Abdul B Mir
Owner
8506825174

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