Individual
BHABA MISRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
Mailing address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0102202934
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215198700
—
VA
Enumeration date
06/18/2008
Last updated
04/22/2015
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