Individual
SHALINI MITTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2100 BULL ST, COLUMBIA, SC 29201-2104
(803) 898-8405
Mailing address
2414 BULL ST, COLUMBIA, SC 29201-1906
(803) 898-8461
(803) 898-8429
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21854
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218543
—
SC
Enumeration date
07/01/2006
Last updated
11/19/2020
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