DR. DWIGHT PAUL MIRMOW (NPI# 1730173493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730173493 |
| Entity Type | Individual |
| Full Name | DR. DWIGHT PAUL MIRMOW |
| Credential | M.D. |
| Practice Address |
2260 Lurightsboro Rd Laboratory Medicine, PC Augusta GA 30904 |
| Mailing Address |
2321 Kings Way Laboratory Medicine, PC Augusta GA 30904 |
| Practice Telephone | 7064817473 |
| Practice Fax Number | 7064817868 |
| Mailing Telephone | 7064817473 |
| Mailing Fax Number | 7064817868 |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2017-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
048805 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
2260 LURIGHTSBORO RD LABORATORY MEDICINE, PC |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255957148 | Thomas E Cotter | Pathology | 1120 15th St # Bf-103b, Augusta, GA 30912-0004 | 2020-06-17 |
| 1386269835 | Pramila Pallikkappara Moideen | Pathology | Augusta University Medical Center Room Bf-103-b, Augusta, GA 30912-0001 | 2020-06-10 |
| 1720200306 | Scott Christopher Drury | Pathology | 2638 Coventry Rd, Augusta, GA 30909-6106 | 2007-05-03 |
| 1417000100 | Alvin B Bryan Jr. | Pathology | 1520 N Leg Rd, Augusta, GA 30909-4332 | 2007-01-18 |
| 1972686749 | David L Booker | Pathology | 1462 Laney Walker Blvd, Ca-2105, Augusta, GA 30912-0003 | 2006-10-23 |
| 1356379127 | Charles Beacham | Pathology | 3505 Lost Tree Ln, Augusta, GA 30907-9516 | 2006-06-29 |
| 1912948050 | Mark David Gusack | Pathology | 1 Center St, Augusta, ME 04330-6410 | 2006-06-09 |
| 1861018772 | Kiran Madwani | Pathology | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-17 |
| 1669097770 | Nivin Omar | Pathology | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-15 |
| 1932724010 | Ahmed Arfa | Pathology | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-14 |
| Find all providers in AUGUSTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.