Individual
PRABHAS MITTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, NEOPLASTIC DISEASES, MILWAUKEE, WI 53226-3522
(414) 805-6800
(414) 805-0618
Mailing address
9200 W WISCONSIN AVE, NEOPLASTIC DISEASES, MILWAUKEE, WI 53226-3522
(414) 805-6800
(414) 805-0618
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
50320
WI
207RX0202X
Medical Oncology Physician
MD00041314
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0164822
L&I
WA
05
—
1366476319
—
WI
05
—
8331225
—
WA
Enumeration date
07/10/2006
Last updated
10/01/2020
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