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NPI Code Detail

MEDICARE: MARINA MIRKOVIC MD

MEDICARE: MARINA MIRKOVIC 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
1207R00000XInternal Medicine Physician81437CT

General Provider Information

NPI Number : 1407593528
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARINA MIRKOVIC MD
Provider Business Mailing Address
First Line : 1 HOSPITAL PLZ
Second Line :
City : STAMFORD
State : CT
Zip : 06902-3602
Country : US
Telephone Number : 203-276-7147
Fax Number :
Provider Business Practice Location Address
First Line : 1 HOSPITAL PLZ
Second Line :
City : STAMFORD
State : CT
Zip : 06902-3602
Country : US
Telephone Number : 203-276-7147
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2022
Last Update Date : 12/10/2025

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