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General NPI Number Information
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NPI Number | 1760589816
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Entity Type | Individual
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Provider Name | RICHARD V MIRON M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 10/12/2015
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Provider Practice Location Address
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Address Line | 505 NASHUA RD 7
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City | DRACUT
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State | MA
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Zip | 01826-1929
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Country | US
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Telephone | 978-674-0271
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Fax | 978-674-0279
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Provider Business Mailing Address
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Address Line | 10 GATEHOUSE RD
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City | AMHERST
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State | MA
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Zip | 01002-2856
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Country | US
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Telephone | 413-253-1250
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Fax | 413-253-1255
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 37986
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License Number State | MA
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