Individual
ISAAC N MITRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1623 N 4TH STREET, TERRE HAUTE, IN 47804
(812) 238-1652
(812) 238-2648
Mailing address
1623 N 4TH STREET, TERRE HAUTE, IN 47804
(812) 238-1652
(812) 238-2648
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01022272A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000082864
BC BS
—
05
—
100250040A
—
IN
Enumeration date
11/02/2006
Last updated
11/22/2011
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