Ms Manisha Mittal, MD | |
413 Allumbaugh St, Ste 101, Boise, ID 83704-9212 | |
(208) 323-1125 | |
(208) 323-9604 |
Full Name | Ms Manisha Mittal |
---|---|
Gender | Female |
Speciality | Internal Medicine |
Location | 413 Allumbaugh St, Boise, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760534424 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | M7355 (Idaho) | Primary |
Entity Name | Dhs/office Of Financial Services Irs/eopc/bmrc/eotc/osh/osh-p |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508802489 PECOS PAC ID: 0547170383 Enrollment ID: O20040130000453 |
Mailing Address | Practice Location Address |
---|---|
Ms Manisha Mittal, MD 413 Allumbaugh St, Ste 101, Boise, ID 83704-9212 Ph: (208) 323-1125 | Ms Manisha Mittal, MD 413 Allumbaugh St, Ste 101, Boise, ID 83704-9212 Ph: (208) 323-1125 |
Dr. Jennifer A Hofstra, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Road, Boise, ID 83706 Phone: 757-446-8920 Fax: 757-446-5242 | |
Dr. James Robert Polk, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-3104 | |
Dr. Michael Frederic Krug, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-5015 Fax: 208-381-1873 | |
Derrel V Walker, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 1055 N Curtis Road, Boise, ID 83706 Phone: 208-367-7350 Fax: 208-367-3951 | |
Dr. Janat E. O'donnell, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 500 W. Fort St., # 111, Boise, ID 83702 Phone: 208-422-1325 Fax: 208-422-1319 | |
Carl L Durning, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 6094 W Emerald St, Boise, ID 83704 Phone: 208-367-6575 Fax: 208-367-6597 | |
Dr. Christopher J Goulet, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 6259 W Emerald St, Boise, ID 83704 Phone: 208-489-1900 Fax: 208-375-5286 |