Individual ProviderMahshid MirInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701(260) 672-6620PECOS EnrollmentBased on the most recent information from CMS, provider Mahshid Mir is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1043848724Provider TypeIndividualFull NameMir, MahshidGenderFemaleSole ProprietorYesEnumeration Date3/30/2020Last Updated9/5/2023Contact InformationPractice LocationPractice Address11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701Phone(260) 672-6620Fax(260) 672-6639Mailing LocationMailing Address11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense01090550AIndianaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer