Basic Information
| Provider Information | |||||||||
| NPI: | 1346637162 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MIAN | ||||||||
| FirstName: | TAIMUR | ||||||||
| MiddleName: | KHALID | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 627 S. EDWIN C. MOSES BLVD | ||||||||
| Address2: | EAST MEDICAL PLAZA, 1ST FLOOR | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372238840 | ||||||||
| FaxNumber: | 9372230758 | ||||||||
| Practice Location | |||||||||
| Address1: | 6950 HILLSDALE CT | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462502040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176217740 | ||||||||
| FaxNumber: | 3176217608 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2015 | ||||||||
| LastUpdateDate: | 09/03/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2084P0800X | 01081456A | IN | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.