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BIBHUTI B MISHRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6845 ELM ST STE 700, MC LEAN, VA 22101-3851
(703) 356-1105
(703) 356-0970
Mailing address
PO BOX 791093, BALTIMORE, MD 21279-1093

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
0101047021
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007101741
VA
Enumeration date
06/22/2006
Last updated
12/05/2011
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