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Individual
PREETI GAUTAM MISRA
Active
Individual
PREETI GAUTAM MISRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301085344
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105344514
—
MI
01
—
110F336360
BCBSM
MI
01
—
1346398971
GROUP NPI
MI
01
—
207R00000X
TAXONOMY
MI
01
—
PM085344
LICENSE
MI
Enumeration date
02/03/2008
Last updated
09/30/2020
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