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General NPI Number Information
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NPI Number | 1013984483
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Entity Type | Individual
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Provider Name | ATUL K MISHRA MD
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Gender | Male
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Dates
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Enumeration Date | 03/03/2006
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Last Update Date | 08/18/2016
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Provider Practice Location Address
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Address Line | 1420 EAST COLLEGE DRIVE
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City | MARSHALL
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State | MN
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Zip | 56258
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Country | US
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Telephone | 507-532-9631
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Fax | 507-532-1176
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Provider Business Mailing Address
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Address Line | 1521 CARLSON ST
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City | MARSHALL
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State | MN
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Zip | 56258-2626
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Country | US
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Telephone | 507-532-1101
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Fax | 507-532-1137
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35763
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License Number State | MN
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