Miray Medical Corp

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

71989 Issued in MA

Legal business name

MIRAY MEDICAL CORP

Practice address

348 N Pearl St
Brockton, MA 02301-1197

Phone

(508) 586-8012

Fax

(508) 583-2779

NPI assigned

Jun 18, 2007

Organization subpart

No

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

Authorized official

Name

Renolt Samaan, MD

Title

President

Phone

(508) 586-8012

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396940573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011197",
            "telephone_number": "508-586-8012",
            "fax_number": "508-583-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011197",
            "telephone_number": "508-586-8012",
            "fax_number": "508-583-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRAY MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAMAAN",
        "authorized_official_first_name": "RENOLT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-586-8012",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "71989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9768033",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie I Minton
• Zulfiqar Ali Mir, M.D
• Lanise Sofia Miranda- Alves
• Anna G. Miranda
• Luana Miranda
• Carolyn Mires, PHD
• Joy Mirrione, LICSW
• Melissa Mirza, PT, DPT
• Mission Possible Concierge Services
• Avery Mitchell

• Internal Medicine Physician in Brockton, MA
• Providers in Brockton, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.