Provider Demographics
NPI:1255467221
Name:HELEN K MIRAU MD LLC
Entity Type:Organization
Organization Name:HELEN K MIRAU MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:MIRAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-293-3680
Mailing Address - Street 1:2600 FAR HILLS AVE
Mailing Address - Street 2:STE 204
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45419-1642
Mailing Address - Country:US
Mailing Address - Phone:937-293-3680
Mailing Address - Fax:937-293-3698
Practice Address - Street 1:2600 FAR HILLS AVE
Practice Address - Street 2:STE 204
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45419-1642
Practice Address - Country:US
Practice Address - Phone:937-293-3680
Practice Address - Fax:937-293-3698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHESP05151Medicare PIN