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NPI Code Detail

MEDICARE: SHALINI MITTAL M.D.

MEDICARE: SHALINI MITTAL 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
1207R00000XInternal Medicine Physician21854SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538198676
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHALINI MITTAL M.D.
Provider Business Mailing Address
First Line : 2414 BULL ST
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-1906
Country : US
Telephone Number : 803-898-8461
Fax Number : 803-898-8429
Provider Business Practice Location Address
First Line : 2100 BULL ST
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-2104
Country : US
Telephone Number : 803-898-8405
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2006
Last Update Date : 11/19/2020

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Directions to “ SHALINI MITTAL M.D.” Practice Location

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