Provider Demographics
NPI:1659578201
Name:MIRZA HAMIRANI
Entity Type:Organization
Organization Name:MIRZA HAMIRANI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:MIRZA
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAMIRANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-424-4777
Mailing Address - Street 1:600 18TH ST
Mailing Address - Street 2:SUITE 412
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101
Mailing Address - Country:US
Mailing Address - Phone:304-424-4777
Mailing Address - Fax:304-424-4847
Practice Address - Street 1:600 18TH ST
Practice Address - Street 2:SUITE 412
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3231
Practice Address - Country:US
Practice Address - Phone:304-424-4777
Practice Address - Fax:304-424-4847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20965174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty