Michael J Mirro
Geriatric Medicine Internist - Cardiovascular Disease Clinical Cardiac Electrophysiologist
11108 Parkview Circle Dr
Fort Wayne
, Indiana 46845-1730
Michael J Mirro
Geriatric Medicine Internist - Cardiovascular Disease Clinical Cardiac Electrophysiologist
11108 Parkview Circle Dr
Fort Wayne
, Indiana 46845-1730
(260) 266-8213
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About
Features
Specialties
- Internist - Cardiovascular Disease
- Clinical Cardiac Electrophysiologist
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Michael J Mirro
- 3926 New Vision Dr
- Fort Wayne, IN
- Zip : 46845-1712
- Phone : (260) 266-8213
Second Address
- Michael J Mirro
- 11108 Parkview Circle Dr
- Fort Wayne, IN
- Zip : 46845-1730
- Fax : (260) 266-5920
- Phone : (260) 266-5700
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RC0000X | Internist - Cardiovascular Disease | 01025414A | IN |
| N | 207RC0001X | Clinical Cardiac Electrophysiologist | 01025414A | IN |
| N | 207RG0300X | Geriatric Medicine | 01025414A | IN |
National Provider Identifier
| NPI | 1053303222 |
|---|---|
| Provider Name | Michael J Mirro |
| First Address | Fort Wayne, IN 46845-1712 |
| Second Address | Fort Wayne, IN 46845-1730 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/08/2005 |
| Last Update Date | 21/04/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000641091 | ANTHEM (01) | IN |
| 0509079 | (05) | OH |
| 060070554 | RR MEDICARE (01) | IN |
| 100138540 | (05) | IN |
| D94469 | (02) | IN |
| P00782366 | R.R. MEDICARE (01) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.