Mishra, Mithilesh J

Mishra, Mithilesh J is an sole proprietor health care provider with primary practice located at 1400 Michigan St Ne , Grand Rapids MI 49503-2032. She recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as her primary health care specialty. Mishra, Mithilesh J can be contacted via phone (616) 454-5278.

Contact Information

Primary practice address
1400 Michigan St Ne Grand Rapids MI 49503-2032
Phone: (616) 454-5278
Fax: (616) 454-4030
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X MM043037 Michigan

Profile Details

NPI number 1710977723
LBN Legal business name Mishra, Mithilesh J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 21st, 2005
Last updated Oct 25th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710977723 NPPES
Michigan MEDICAID 1540509

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