Individual
MANOJ MITTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 W ORANGE GROVE RD, STE 510, TUCSON, AZ 85704-1139
(520) 219-1539
(520) 797-6704
Mailing address
2001 W ORANGE GROVE RD, STE 510, TUCSON, AZ 85704-1139
(520) 219-1539
(520) 797-6704
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
29007
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
695744
—
AZ
Enumeration date
07/16/2006
Last updated
12/11/2008
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