| Doctor Name: | DR. MANORAMA MISHRA |
| NPI Number: | 1740416676 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 11487 |
| Business Practice Address: | 8301 Farrow Rd Columbia, SC - 292033245 |
| Business Phone Number: | 8039356728 |
| Business Fax Number: | 8039355081 |
| Mailing Address: | 8301 Farrow Rd., COLUMBIA |
| State: | SC |
| Postal Code: | 292033245 |
| Phone Number: | 8039356728 |
| Fax Number: | 8039355081 |
| NPI Enumeration Date: | 06/05/2009 |
| NPI Last Update Date: | 06/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 11487 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |