MEDICARE: AHMAD RAJIH MIRI

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	2080P0206X	Pediatric Gastroenterology Physician	8382	NE

General Provider Information

NPI Number	:	1477032647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMAD RAJIH MIRI

Provider Business Mailing Address
First Line	:	982161 NEBRASKA MEDICAL CENTER PEDIATRICS DEPARTMENT
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-2161
Country	:	US
Telephone Number	:	402-559-2412
Fax Number	:

Provider Business Practice Location Address
First Line	:	982161 NEBRASKA MEDICAL CENTER PEDIATRICS DEPARTMENT
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-2161
Country	:	US
Telephone Number	:	402-559-2412
Fax Number	:

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

Provider Enumeration Date	:	08/09/2018
Last Update Date	:	08/09/2018

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