Provider Demographics
NPI:1497285118
Name:AIOUB, MIRIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:
Last Name:AIOUB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 BLAIR RD
Mailing Address - Street 2:
Mailing Address - City:PORT READING
Mailing Address - State:NJ
Mailing Address - Zip Code:07064-1806
Mailing Address - Country:US
Mailing Address - Phone:732-570-0150
Mailing Address - Fax:
Practice Address - Street 1:3401 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5103
Practice Address - Country:US
Practice Address - Phone:215-707-3187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT213735207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology