Individual
DR. KAMLA K MISHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 SCHUYLKILL MANOR RD, SUITE 5A, POTTSVILLE, PA 17901-3849
(570) 516-9444
(570) 728-2360
Mailing address
82 TUNNEL RD, POTTSVILLE, PA 17901-3869
(570) 622-5455
(570) 622-5493
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD059125L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015971720002
—
PA
01
—
0015971720004
MA
PA
01
—
50070589
KEYSTONE SPECIALIST
PA
01
—
CB00663
RAILROAD MEDICARE PBA
PA
Enumeration date
01/09/2006
Last updated
01/12/2017
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