Individual
ANUJ MITTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
461 W HURON ST, PONTIAC, MI 48341-1601
(248) 857-7200
Mailing address
461 W HURON ST, PONTIAC, MI 48341-1601
(248) 857-7200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301077841
MI
207Q00000X
Family Medicine Physician
C54077
CA
207R00000X
Internal Medicine Physician
C54077
CA
208M00000X
Hospitalist Physician
Primary
C54077
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4640750
—
MI
Enumeration date
10/13/2006
Last updated
10/04/2017
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