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NPI Code Detail

MEDICARE: SUSHIL CHANDER MITTAL M.D.

MEDICARE: SUSHIL CHANDER MITTAL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician19349SC
2207Q00000XFamily Medicine Physician2022-01003NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679533491
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSHIL CHANDER MITTAL M.D.
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9101 MONROE RD STE 155
Second Line :
City : CHARLOTTE
State : NC
Zip : 28270-2467
Country : US
Telephone Number : 704-384-1260
Fax Number : 704-384-1289
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 02/19/2024

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Directions to “ SUSHIL CHANDER MITTAL M.D.” Practice Location

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