Provider Demographics
NPI:1871891507
Name:MIRANDA, ALTORY MUSNI JR (MD)
Entity type:Individual
Prefix:DR
First Name:ALTORY
Middle Name:MUSNI
Last Name:MIRANDA
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:16313 FALCONERS TER
Mailing Address - Street 2:
Mailing Address - City:MOSELEY
Mailing Address - State:VA
Mailing Address - Zip Code:23120-1655
Mailing Address - Country:US
Mailing Address - Phone:804-554-6134
Mailing Address - Fax:410-569-7137
Practice Address - Street 1:16313 FALCONERS TER
Practice Address - Street 2:
Practice Address - City:MOSELEY
Practice Address - State:VA
Practice Address - Zip Code:23120-1655
Practice Address - Country:US
Practice Address - Phone:804-554-6134
Practice Address - Fax:410-569-7137
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2016-11-10
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Provider Licenses
StateLicense IDTaxonomies
VA0101249211208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice