Doctor Name: | SATYA M MISHRA |
NPI Number: | 1346245321 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 01057402A |
Business Practice Address: | 524 E Mckinley Ave Mishawaka, IN - 465456285 |
Business Phone Number: | 5742562556 |
Business Fax Number: | 5742584278 |
Mailing Address: | 524 E Mckinley Ave, MISHAWAKA |
State: | IN |
Postal Code: | 465456285 |
Phone Number: | 5742562556 |
Fax Number: | 5742584278 |
NPI Enumeration Date: | 06/16/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01057402A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |