Provider Demographics
NPI:1457370231
Name:GARCIA, MIRIAM P (MD)
Entity Type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:P
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2436 COLONY CROSSING PL
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4281
Mailing Address - Country:US
Mailing Address - Phone:804-302-4400
Mailing Address - Fax:804-601-2515
Practice Address - Street 1:2436 COLONY CROSSING PL
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4281
Practice Address - Country:US
Practice Address - Phone:804-302-4400
Practice Address - Fax:804-601-2515
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01011023822084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH62593Medicare UPIN
VA002054M85Medicare PIN