Organization
KUNAL MITRA MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KUNAL MITRA MD (OWNER)
(330) 725-7100
Entity
Organization
Contact information
Practice address
3575 RESERVE COMMONS DR, SUITE 150, MEDINA, OH 44256
(330) 725-7100
(330) 725-3084
Mailing address
3575 RESERVE COMMONS DR, SUITE 150, MEDINA, OH 44256
(330) 725-7100
(330) 725-3084
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35052774M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0709559
—
OH
Enumeration date
07/23/2008
Last updated
07/23/2008
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