Individual
SHWETA MISHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
894 E 3900 S, #B, SALT LAKE CITY, UT 84107-2151
(215) 368-2100
Mailing address
PO BOX 9677, #B, SALT LAKE CITY, UT 84109-9677
(215) 361-4854
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD435566
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102291017
—
PA
Enumeration date
08/31/2006
Last updated
03/26/2015
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