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General NPI Number Information
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NPI Number | 1578823324
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Entity Type | Individual
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Provider Name | MARIAH SALIM MITHAIWALA DO
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Gender | Female
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Dates
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Enumeration Date | 05/25/2012
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 4835 LBJ FWY STE 900
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City | DALLAS
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State | TX
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Zip | 75244-6001
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Country | US
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Telephone | 972-520-8124
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Fax |
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Provider Business Mailing Address
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Address Line | 4835 LYNDON B JOHNSON FWY STE 900
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City | DALLAS
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State | TX
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Zip | 75244-6001
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Country | US
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Telephone | 214-460-9268
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 5101019980
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | Q4470
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 5101019980
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 02005805A
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License Number State | IN
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