Mirvis, Bruce Robert

Mirvis, Bruce Robert is an individual health care provider with primary practice located at 1070 Polaris Pkwy Suite 100, Columbus OH 43240-4038. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Mirvis, Bruce Robert can be contacted via phone (614) 437-5600.

Contact Information

Primary practice address
1070 Polaris Pkwy Suite 100 Columbus OH 43240-4038
Phone: (614) 437-5600
Fax: (614) 437-6275
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301116689 Michigan
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2018042193 Missouri
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35.039260 Ohio

Profile Details

NPI number 1568434835
LBN Legal business name Mirvis, Bruce Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated Feb 9th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568434835 NPPES
Ohio MEDICAID 0345086

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