Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 35067061 | OH |
NPI | 1003831231 |
---|---|
Provider Name | David Michael Miranda |
First Address | Dayton, OH 45432-1400 |
Second Address | Dayton, OH 45432-1400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 23/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2159275 | (05) | OH |