Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Bruce Robert Mirvis, MD

Individual provider Pediatrics Physician · NPI 1568434835

Dr. Bruce Robert Mirvis, MD is a Pediatrics Physician in Columbus, Ohio. Works from 4 locations. Licensed in Michigan, Missouri and Ohio.

Licensed in
MI, MO, OH
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1070 Polaris Pkwy Ste 100
Columbus, OH 43240-4038
Phone: (614) 437-5600
Fax: (614) 437-6275
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 19515 Brune Pkwy, Warrenton, MO 63383-6505 — (888) 403-1071
  • 8501 Old Troy Pike, Huber Heights, OH 45424-1054 — (937) 641-4360
  • 3333 W Tech Rd, Miamisburg, OH 45342-0955 — (937) 641-5725

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 35.039260 (OH)
Pediatrics Physician Taxonomy 208000000X · Licence 4301116689 (MI)
Pediatrics Physician Taxonomy 208000000X · Licence 2018042193 (MO)

Record details

NPI number1568434835
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 2, 2006
Last updated in NPPESFebruary 9, 2023
Certification dateFebruary 9, 2023
Mailing address1070 Polaris Pkwy, Suite 100, Columbus, OH 43240-4038

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