Abdul B Mir MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0032883 Issued in FL

Legal business name

ABDUL B MIR MD PA

Practice address

131 E Redstone Ave
Suite 101
Crestview, FL 32539-5326

Phone

(850) 682-5174

Fax

(850) 689-3653

NPI assigned

Dec 11, 2009

Last updated

Dec 11, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Abdul B MirNPI 1124052014

Title

Owner

Phone

(850) 682-5174

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Abdul Basit Mir, M.D.

  • Internal Medicine Physician
  • Crestview, FL
  • NPI 1124052014
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260489600000",
    "number": "1255660775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 E REDSTONE AVE",
            "address_2": "SUITE 101",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395326",
            "telephone_number": "850-682-5174",
            "fax_number": "850-689-3653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 E REDSTONE AVE",
            "address_2": "SUITE 101",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395326",
            "telephone_number": "850-682-5174",
            "fax_number": "850-689-3653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABDUL B MIR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-11",
        "last_updated": "2009-12-11",
        "status": "A",
        "authorized_official_last_name": "MIR",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-682-5174"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0032883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Crestview, FL
• Providers in Crestview, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.