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1033143599

NPI Code Detail

MEDICARE: AMRENDRA SINGH MIRANPURI MD

MEDICARE: AMRENDRA SINGH MIRANPURI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	270148	NY
2	207T00000X	Neurological Surgery Physician	34528	SC
3	207T00000X	Neurological Surgery Physician	1823	WI
4	207T00000X	Neurological Surgery Physician	036144501	IL

General Provider Information

NPI Number	:	1033143599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMRENDRA SINGH MIRANPURI MD

Provider Business Mailing Address
First Line	:	611 W. PARK ST.
Second Line	:	FAPC
City	:	URBANA
State	:	IL
Zip	:	61801
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 N LINCOLN AVE
Second Line	:
City	:	URBANA
State	:	IL
Zip	:	61801-2432
Country	:	US
Telephone Number	:	217-383-3507
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	01/23/2025

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Directions to “ AMRENDRA SINGH MIRANPURI MD” Practice Location

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