Individual
MITESH S BHALALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
35 SUMMER ST, TAUNTON, MA 02780-3469
(508) 821-4100
(508) 822-2367
Mailing address
189 QUINCY ST, BROCKTON, MA 02302-2967
(508) 588-6700
(508) 584-3010
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
266145
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110118206A
—
MA
Enumeration date
05/17/2010
Last updated
07/21/2022
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