Provider Demographics
NPI:1750554432
Name:MIRCA INTERNAL MEDICINE ASSOCIATES,LTD
Entity type:Organization
Organization Name:MIRCA INTERNAL MEDICINE ASSOCIATES,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-497-5271
Mailing Address - Street 1:835 E SOUTHERN AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-5026
Mailing Address - Country:US
Mailing Address - Phone:480-497-5270
Mailing Address - Fax:480-497-2615
Practice Address - Street 1:835 E SOUTHERN AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-5026
Practice Address - Country:US
Practice Address - Phone:480-497-5270
Practice Address - Fax:480-497-2615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15645207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZE35004Medicare UPIN