Organization
KABINDRA N MISHRA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KABINDRA N MISHRA MD (OWNER)
(517) 787-3900
Entity
Organization
Contact information
Practice address
1100 E MICHIGAN AVE, SUITE 308, JACKSON, MI 49201-1847
(517) 787-3900
Mailing address
1100 E MICHIGAN AVE, SUITE 308, JACKSON, MI 49201-1847
(517) 787-3900
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
KM033204
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1196630001
MEDICARE DMERC
MI
01
—
2003811701
BCBSM
MI
05
—
2105656
—
MI
01
—
P58871
BLUE CARE NETWORK
MI
Enumeration date
02/15/2008
Last updated
02/15/2008
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