Individual
JAY MITTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
295 STONER AVE STE 102, WESTMINSTER, MD 21157-5662
(410) 848-1818
(410) 871-7964
Mailing address
295 STONER AVE STE 102, WESTMINSTER, MD 21157-5662
(410) 848-1818
(410) 871-7964
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D0082611
MD
208600000X
Surgery Physician
MT197069
PA
390200000X
Student in an Organized Health Care Education/Training Program
57.020479
OH
390200000X
Student in an Organized Health Care Education/Training Program
MT197069
PA
Other
Enumeration date
05/10/2010
Last updated
10/07/2024
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