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General NPI Number Information
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NPI Number | 1689776825
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Entity Type | Organization
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Legal Business Name | RALPH A MIRANDA MD
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 196 OLD ROUTE 30
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City | GREENSBURG
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State | PA
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Zip | 15601
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Country | US
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Telephone | 724-838-7632
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Fax | 724-836-3655
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Provider Business Mailing Address
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Address Line | 196 OLD ROUTE 30
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City | GREENSBURG
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State | PA
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Zip | 15601
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Country | US
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Telephone | 724-838-7632
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Fax | 724-836-3655
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Authorized Official
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Title or Position | OWNER
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Name | RALPH A MIRANDA
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Credential | MD
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Telephone | 724-838-7632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD019744E
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License Number State | PA
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