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NPI Code Detail

MEDICARE: DR. KAREN K MIURA MD

MEDICARE: DR. KAREN K MIURA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianMD014479EPA

General Provider Information

NPI Number : 1043233414
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAREN K MIURA MD
Provider Business Mailing Address
First Line : 1810 S. RITTENHOUSE SQUARE
Second Line : SUITE 1801
City : PHILADELPHIA
State : PA
Zip : 19103-5827
Country : US
Telephone Number : 215-735-1716
Fax Number : 215-731-1466
Provider Business Practice Location Address
First Line : 1810 RITTENHOUSE SQ
Second Line : SUITE 1801
City : PHILADELPHIA
State : PA
Zip : 19103-5837
Country : US
Telephone Number : 215-735-1716
Fax Number : 215-731-1466
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 07/09/2007

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