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General NPI Number Information
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NPI Number | 1518133792
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Entity Type | Individual
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Provider Name | ALTIN MIRAKA DO
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Gender | Male
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 1500 WEISS ST
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City | SAGINAW
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State | MI
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Zip | 48602-5251
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Country | US
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Telephone | 989-497-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 WEISS ST
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City | SAGINAW
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State | MI
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Zip | 48602-5251
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Country | US
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Telephone |
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 34C.000290
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 5315052451
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 5101019268
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 02005220A
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License Number State | IN
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