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General NPI Number Information
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NPI Number | 1437151115
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Entity Type | Individual
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Provider Name | DAVID MIERZWIAK MD
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Gender | Male
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 10/14/2009
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Provider Practice Location Address
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Address Line | 2801 BAY PARK DR
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City | OREGON
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State | OH
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Zip | 43616-4920
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Country | US
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Telephone | 419-690-7900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 633390
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City | CINCINNATI
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State | OH
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Zip | 45263-3390
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Country | US
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Telephone | 800-594-1876
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 35056910
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License Number State | OH
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