Individual provider · Type 1 NPI

Gennady G. Miroshnichenko, MD

Gynecologic Oncology Physician · Fort Worth, TX

NPI number 1164784450 Active

Practice location

1201 S Main St
Fort Worth, TX 76104-4804

Call (817) 702-6500 Map

Fax (817) 702-6561

Mailing address

PO Box 732973
Dallas, TX 75373-2973

Specialties and licenses

TaxonomyCodeLicense
Obstetrics & Gynecology Physician 207V00000XP4595 (TX)
Gynecologic Oncology Physician Primary 207VX0201XP4595 (TX)

Gynecologic Oncology Physician: An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.

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About NPI 1164784450

Gennady G. Miroshnichenko, MD's National Provider Identifier is 1164784450, issued on Jun 12, 2012. The primary taxonomy on file is Gynecologic Oncology Physician (207VX0201X), and the practice location is in Fort Worth, TX. The record was last updated on Feb 1, 2021.