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Individual

DR. SANJEEB K MISHRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10 SAINT PATRICKS DR STE D, WALDORF, MD 20603-4527
(301) 645-8322
(301) 645-6229
Mailing address
10 SAINT PATRICKS DR, WALDORF, MD 20603-4527
(301) 373-7900
(301) 373-6900

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
D23021
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
018131500
MD
01
390003283
RAILROAD MEDICARE
MD
Enumeration date
02/02/2006
Last updated
12/13/2021
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