Physician Assistant
MIRANDA BASTO PAC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1538965256 · enumerated 2025-02-22 · record updated 2025-07-25. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Practice location 1900 RIVERSIDE PKWY, LAWRENCEVILLE, GA, 30043-5925 (770) 237-3475 Fax (770) 237-3756 Google Maps Apple Maps OpenStreetMap
- Mailing address 1900 RIVERSIDE PKWY, LAWRENCEVILLE, GA, 30043-5925 (770) 237-3475 Fax (770) 237-3756 Google Maps Apple Maps OpenStreetMap
Specialties
- Physician Assistant 363A00000X · Primary · License 13251 GA
In this directory
Locations and evidence
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Practice location
LAWRENCEVILLE, GA, 300435925
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.