Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 3305 | AZ |
NPI | 1043285299 |
---|---|
Provider Name | Dr. Mitar Vranic |
First Address | Mesa, AZ 85207-6415 |
Second Address | Mesa, AZ 85207-6415 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 04/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G14609 | (02) | AZ |