Individual
NUPUR MISHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N MACON ST, MACON, GA 31210-6563
(478) 765-4520
Mailing address
300 W OAK ST STE 200, CARBONDALE, IL 62901-1400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
109629
GA
207Q00000X
Family Medicine Physician
125080015
IL
Other
Enumeration date
06/29/2022
Last updated
12/05/2025
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