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General NPI Number Information
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NPI Number | 1306674882
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Entity Type | Individual
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Provider Name | PRIYA MISHRA MD
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Gender | Female
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 1101 W UNIVERSITY DR
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City | ROCHESTER
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State | MI
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Zip | 48307-1863
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Country | US
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Telephone | 248-652-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 434 PINEHURST DR
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-1243
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Country | US
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Telephone | 248-832-7969
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4351053070
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License Number State | MI
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