Healthcare Provider Details

I. General information

NPI: 1891727897
Provider Name (Legal Business Name): NANHI MITTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 06/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS STREET ZAYED 6208
BALTIMORE MD
21287
US

IV. Provider business mailing address

1800 ORLEANS STREET ZAYED 6208
BALTIMORE MD
21287
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-7519
  • Fax: 410-955-0994
Mailing address:
  • Phone: 410-955-7519
  • Fax: 410-955-0994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036-116121
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD67629
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: