Individual
DR. RAMAN L. MITRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
610 N MICHIGAN ST, SUITE 400, SOUTH BEND, IN 46601-1077
(574) 647-8120
(574) 647-8111
Mailing address
610 N MICHIGAN ST, SUITE 400, SOUTH BEND, IN 46601-1077
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
01045628A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200102610
—
IN
Enumeration date
06/09/2005
Last updated
07/26/2012
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