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General NPI Number Information
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NPI Number | 1205418589
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Entity Type | Individual
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Provider Name | SHIV KUMAR MISRA DO
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Gender | Male
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Dates
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Enumeration Date | 04/26/2021
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 401 MATTHEW ST
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City | MARIETTA
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State | OH
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Zip | 45750-1635
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Country | US
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Telephone | 740-374-7700
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Fax | 740-374-7701
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Provider Business Mailing Address
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Address Line | 400 ASSOCIATION DR STE 102
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City | CHARLESTON
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State | WV
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Zip | 25311-1298
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Country | US
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Telephone | 304-760-7536
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Fax |
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 34.017777
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4621
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 34.017777
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4621
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License Number State | WV
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 4621
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License Number State | WV
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