Mirja Monica Wirtz, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

MT217244 Issued in PA

Practice address

100 N Academy Ave
Danville, PA 17822-9800

Phone

(570) 271-6211

NPI assigned

Mar 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1902366610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 HOLLOW DR",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178216509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTZ",
        "first_name": "MIRJA",
        "middle_name": "MONICA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT217244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peyton Wilson
• Thomas William Wilson, MD
• Joel Benjamin Winnick, PHD
• Tyler John Wirfel
• Mackenzie Wirth
• Jeffrey Gregory Wojciechowski
• Beth A. Wojtowicz, PA-C
• Christine Wolcott, M.D.
• Erin Elisabeth Wolfe, LPN
• Heather Marie Moyer Wolfe

• Student in an Organized Health Care Education/Training Program in Danville, PA
• Providers in Danville, PA by specialty
• Student in an Organized Health Care Education/Training Program in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.