Organization
DIBYAJIBAN MAHAPATRA,M.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIBYAJIBAN MAHAPATRA M.D. (PHYSICIAN)
(256) 883-6966
Entity
Organization
Contact information
Practice address
185 WHITESPORTS DRIVE, SUITE NO. 7, HUNTSVILLE, AL 35801
(256) 883-6966
(256) 883-6432
Mailing address
16025 MICHELLE DRIVE, HUNTSVILLE, AL 35803
(256) 883-6125
(256) 883-6432
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20939
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529911790
—
AL
Enumeration date
01/08/2007
Last updated
09/09/2008
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