Poonam Mishra is a Adult Medicine in Melbourne, Florida. Poonam Mishra practices all healthcare services and medical treatments related to Adult Medicine. The NPI Number for Poonam Mishra is 1306836952. The last update date is 2015-02-06.
Poonam Mishra's current location address is 401 N Wickham Rd, Melbourne, Florida. You can contact this provider via phone number 3217575105 and fax number 3217575104. The mailing address for Poonam Mishra is 401 N Wickham Rd, Melbourne, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Poonam Mishra |
|---|---|
| Address | 401 N Wickham Rd, Melbourne, Florida |
| Phone Number | 3217575105 |
| Fax Number | 3217575104 |
| Sole Proprietor | N |
| Credentials | D.O. |
NPI Number Detail
| NPI Number | 1306836952 |
|---|---|
| Provider Enumeration Date | 2005-10-25 |
| Last Updated Date | 2015-02-06 |
Provider Mailing Address Detail
| Address | 401 N Wickham Rd |
|---|---|
| City | Melbourne |
| State | Florida (FL) |
| Post Code | 329358659 |
| Phone Number | 3217575105 |
| Fax Number | 3217575104 |
Provider's Primary Taxonomy Detail
| Speciality | Adult Medicine |
|---|---|
| Taxonomy | 207Qa0505X |
| Licence No | 593360315 |
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Definition: The NUCC recommends this code not be used. Choose a more appropriate code. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 40462 | FL | BCBS MAB GROUP | |
| 57174 | FL | BCBS PROVIDER ID |
Post Comment/ Review Below
What is the unique provider identifier assigned to Poonam Mishra?
The Poonam Mishra has been issued the NPI (National Provider Identifier) 1306836952 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where Poonam Mishra is geographically located?
The Poonam Mishra is physically situated at the following location: 401 N Wickham Rd, Melbourne, FL, 329358659.
When did Poonam Mishra receive its 1306836952 assignment?
The Poonam Mishra was assigned its 1306836952 on 2005-10-25, which is the date when this unique identifier was issued to the organization.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1306836952 to Poonam Mishra?
The Centers for Medicare & Medicaid Services originally issued the 1306836952 to Poonam Mishra on 2005-10-25.
As of what date were the details pertaining to Poonam Mishra last refreshed?
The information related to the Poonam Mishra, including its address, specialty, and other relevant details, was last updated on 2015-02-06.
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