Individual
DR. KAMRUDIN MITHANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1106 REVOLUTION ST, HAVRE DE GRACE, MD 21078-3721
(410) 939-1050
(410) 939-2010
Mailing address
1106 REVOLUTION ST, HAVRE DE GRACE, MD 21078-3721
(410) 939-1050
(410) 939-2010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D32609
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
380121700
—
MD
01
—
5973
RRMC
GA
Enumeration date
09/27/2005
Last updated
01/17/2010
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