Individual
SUBHAM MITRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
43825 MICHIGAN AVE, CANTON, MI 48188-2551
(248) 788-9286
Mailing address
31185 WELLINGTON DR APT 28203, NOVI, MI 48377-4193
(248) 946-6248
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704370209
MI
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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