Provider Demographics
NPI:1417519869
Name:MIR, RUMANA K
Entity Type:Individual
Prefix:
First Name:RUMANA
Middle Name:K
Last Name:MIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2292A CHAMBLEE TUCKER RD
Mailing Address - Street 2:
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-3457
Mailing Address - Country:US
Mailing Address - Phone:404-775-6522
Mailing Address - Fax:770-455-6522
Practice Address - Street 1:2292 CHAMBLEE TUCKER RD STE A
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-3457
Practice Address - Country:US
Practice Address - Phone:404-775-6522
Practice Address - Fax:770-455-6522
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-06
Last Update Date:2019-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health