Van Dam, Miranda Michelle

Van Dam, Miranda Michelle is an individual health care provider with primary practice located at 500 S. Eagle Rd. , Meridian ID 83642. She recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Surgical Assistant, which is considered as her primary health care specialty. Van Dam, Miranda Michelle can be contacted via phone (208) 706-8101.

Contact Information

Primary practice address
500 S. Eagle Rd. Meridian ID 83642
Phone: (208) 706-8101
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Surgical Assistant 246ZC0007X 205983 Idaho

Profile Details

NPI number 1902565682
LBN Legal business name Van Dam, Miranda Michelle
Credentials CSFA
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 10th, 2021
Last updated Dec 10th, 2021 - about 5 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 1902565682 NPPES
Idaho Other 205983 NATIONAL BOARD OF SURGICAL TECHNOLOGY AND SURGICAL ASSISTING

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