Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 036144501 | IL |
N | 207T00000X | Neurosurgeon | 1823 | WI |
N | 207T00000X | Neurosurgeon | 270148 | NY |
N | 207T00000X | Neurosurgeon | 34528 | SC |
NPI | 1033143599 |
---|---|
Provider Name | Amrendra S. Miranpuri |
First Address | Urbana, IL 61801 |
Second Address | Urbana, IL 61801-2432 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 05/02/2021 |