MEDICARE: RICHARD D MIREL 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	40244	MA

General Provider Information

NPI Number	:	1437150174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD D MIREL M.D.

Provider Business Mailing Address
First Line	:	55 FOGG RD
Second Line	:
City	:	WEYMOUTH
State	:	MA
Zip	:	02190-2432
Country	:	US
Telephone Number	:	781-340-4035
Fax Number	:	781-340-3782

Provider Business Practice Location Address
First Line	:	55 FOGG RD
Second Line	:
City	:	WEYMOUTH
State	:	MA
Zip	:	02190-2432
Country	:	US
Telephone Number	:	781-340-4035
Fax Number	:	781-340-3782

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	07/08/2007

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