Individual
MIRA MAMTANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, GROUND SILVERSTEIN BLDG, PHILADELPHIA, PA 19104-4206
(215) 662-7248
Mailing address
3400 SPRUCE ST, GROUND SILVERSTEIN BLDG, PHILADELPHIA, PA 19104-4206
(215) 662-7248
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD444116
PA
Other
Enumeration date
05/13/2009
Last updated
06/25/2013
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