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1831209923

NPI Code Detail

MEDICARE: MIRIAM EMILE MD

MEDICARE: MIRIAM EMILE 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
1	207R00000X	Internal Medicine Physician	35.071046	OH
2	208M00000X	Hospitalist Physician	35.071046	OH
3	207R00000X	Internal Medicine Physician	196904-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831209923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRIAM EMILE MD

Provider Business Mailing Address
First Line	:	405 W GRAND AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45405-7538
Country	:	US
Telephone Number	:	937-723-3276
Fax Number	:	937-723-3277

Provider Business Practice Location Address
First Line	:	405 W GRAND AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45405-7538
Country	:	US
Telephone Number	:	937-723-3276
Fax Number	:	937-723-3277

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	05/05/2023

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Directions to “ MIRIAM EMILE MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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