Individual
DR. HIMANSHU MITTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2620 N. WESTWOOD BLVD, POPLAR BLUFF, MO 63901
(573) 727-2640
Mailing address
624 JEFFERSON AVENUE, SCRANTON, PA 18510
(570) 955-6336
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2011021601
MO
207R00000X
Internal Medicine Physician
MT192795
PA
Other
Enumeration date
03/04/2009
Last updated
01/18/2012
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