Individual
POONAM MISHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
4301091725
MI
208M00000X
Hospitalist Physician
4301091725
MI
Other
Enumeration date
07/10/2008
Last updated
03/04/2021
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