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NPI Code Detail

MEDICARE: SOMA MITRA M.D.

MEDICARE: SOMA MITRA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianD0070650MD
2207R00000XInternal Medicine PhysicianD0070650MD

General Provider Information

NPI Number : 1386679603
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOMA MITRA M.D.
Provider Business Mailing Address
First Line : 12800 MIDDLEBROOK RD STE 400
Second Line :
City : GERMANTOWN
State : MD
Zip : 20874-5282
Country : US
Telephone Number : 301-327-0266
Fax Number : 866-701-4905
Provider Business Practice Location Address
First Line : 12800 MIDDLEBROOK RD STE 400
Second Line :
City : GERMANTOWN
State : MD
Zip : 20874-5282
Country : US
Telephone Number : 301-327-0266
Fax Number : 866-701-4905
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 01/19/2026

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