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General NPI Number Information
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NPI Number | 1962388173
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Entity Type | Individual
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Provider Name | DR. HOMAN MIRALIABKBARI
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Gender | Male
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 204 MAIN STREET NORTH
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City | PLENTYWOOD
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State | MT
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Zip | 59254
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Country | US
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Telephone | 306-502-9315
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Fax |
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Provider Business Mailing Address
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Address Line | 12111 51 AVE NW SUITE NUMBER 210
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City | EDMONTON
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State | ALBERTA
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Zip | T6H 6A3
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Country | CA
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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 | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 117943
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License Number State | MT
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