Individual
MS. MANISHA MITTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
413 ALLUMBAUGH ST, STE 101, BOISE, ID 83704-9212
(208) 323-1125
(208) 323-9604
Mailing address
413 ALLUMBAUGH ST, STE 101, BOISE, ID 83704-9212
(208) 323-1125
(208) 323-9604
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M7355
ID
Other
Enumeration date
01/16/2007
Last updated
02/18/2010
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