Provider Demographics
NPI:1871520387
Name:MIAN, HAMID A (MD)
Entity type:Individual
Prefix:
First Name:HAMID
Middle Name:A
Last Name:MIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HAMID
Other - Middle Name:A
Other - Last Name:MIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:115 HOOKER AVE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-4933
Mailing Address - Country:US
Mailing Address - Phone:801-388-6291
Mailing Address - Fax:
Practice Address - Street 1:115 HOOKER AVE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4933
Practice Address - Country:US
Practice Address - Phone:801-388-6291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY201151-1174400000X
UT6667067-1205208M00000X, 207RN0300X
CODR.0054162207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5068591OtherAETNA PPO
NY27N391OtherBLUE CROSS/ BLUE SHIELD
NY10057934OtherCDPHP
NY200051608OtherMVP
NY01797093Medicaid
NY2002821OtherAETNA HMO
NYP888216OtherOXFORD
NY200051608OtherMVP