Organization
SANJEEB K. MISHRA M.D., P.A. CHARTERED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANJEEB K MISHRA D23031 (OWNER)
(301) 645-8322
Entity
Organization
Contact information
Practice address
3581 OLD WASHINGTON RD, SUITE D, WALDORF, MD 20602-3270
(301) 645-8322
Mailing address
3581 OLD WASHINGTON RD, SUITE D, WALDORF, MD 20602-3270
(301) 645-8322
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
D3783735
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
69870100
—
MD
01
—
CJ5151
RAILROAD MEDICARE
MD
Enumeration date
11/09/2006
Last updated
02/08/2013
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