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NPI Code Detail

MEDICARE: DR. MICHAEL MIRZOYAN M.D.

MEDICARE: DR. MICHAEL MIRZOYAN M.D.
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
1207RC0200XCritical Care Medicine (Internal Medicine) Physician2016040161MO
2207R00000XInternal Medicine Physician25MA09265600NJ
3207RC0200XCritical Care Medicine (Internal Medicine) Physician15307NV
4207RC0200XCritical Care Medicine (Internal Medicine) Physician4301106904MI
5207RP1001XPulmonary Disease Physician283457NY
6207RC0200XCritical Care Medicine (Internal Medicine) PhysicianS0745TX
7207RP1001XPulmonary Disease Physician5720TN

General Provider Information

NPI Number : 1073787545
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL MIRZOYAN M.D.
Provider Business Mailing Address
First Line : 75 BEEKMAN ST
Second Line :
City : PLATTSBURGH
State : NY
Zip : 12901-1427
Country : US
Telephone Number : 518-561-2000
Fax Number :
Provider Business Practice Location Address
First Line : 75 BEEKMAN ST
Second Line :
City : PLATTSBURGH
State : NY
Zip : 12901-1427
Country : US
Telephone Number : 518-561-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2008
Last Update Date : 10/17/2024

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