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NPI Code Detail

MEDICARE: GINAT W MIROWSKI DMD MD LLC

MEDICARE: GINAT W MIROWSKI DMD MD LLC
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
1174400000XSpecialist01020481AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1POO282321OTHERRRMCARE

General Provider Information

NPI Number : 1992987507
Entity Type Code : Organization
Provider Name (Legal Business Name) : GINAT W MIROWSKI DMD MD LLC
Provider Business Mailing Address
First Line : 1910 N ARLINGTON AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46218-5128
Country : US
Telephone Number : 317-359-5357
Fax Number : 317-359-5358
Provider Business Practice Location Address
First Line : 1910 N ARLINGTON AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46218-5128
Country : US
Telephone Number : 317-359-5357
Fax Number : 317-359-5358
Authorized Official
Title or Position : PHYSICIAN
Name : DR. GINAT WINTERMEYER MIROWSKI
Credential :
Telephone Number : 317-359-5357
Provider Enumeration Date : 12/05/2007
Last Update Date : 02/27/2008

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Directions to “GINAT W MIROWSKI DMD MD LLC ” Practice Location

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