Individual
DR. PRATEEK MISHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-118929
IL
207R00000X
Internal Medicine Physician
Primary
51992-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002889
—
WI
01
—
1104009505
BCBS
WI
Enumeration date
12/10/2007
Last updated
09/17/2024
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