MEDICARE: DR. ALAMGIR MIRZA 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
1	208M00000X	Hospitalist Physician	0101242108	VA
2	207RN0300X	Nephrology Physician	0101242108	VA
3	207R00000X	Internal Medicine Physician	0101242108	VA

General Provider Information

NPI Number	:	1184823338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAMGIR MIRZA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 7068
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23707-0068
Country	:	US
Telephone Number	:	757-686-3508
Fax Number	:	757-686-0541

Provider Business Practice Location Address
First Line	:	2476 NIMMO PKWY STE 109
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-2594
Country	:	US
Telephone Number	:	757-689-0211
Fax Number	:	757-496-3715

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

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	08/03/2019

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