Provider Demographics
NPI:1871889733
Name:MIAN FAMILY MEDICINE, LLC
Entity type:Organization
Organization Name:MIAN FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMSHID
Authorized Official - Middle Name:
Authorized Official - Last Name:MIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-528-6327
Mailing Address - Street 1:6830 HOSPITAL DR
Mailing Address - Street 2:SUITE #104
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4373
Mailing Address - Country:US
Mailing Address - Phone:410-391-7200
Mailing Address - Fax:410-391-7210
Practice Address - Street 1:6830 HOSPITAL DR
Practice Address - Street 2:SUITE #104
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4373
Practice Address - Country:US
Practice Address - Phone:410-391-7200
Practice Address - Fax:410-391-7210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty