Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 8445 | ND |
N | 208200000X | Surgeon | 8445 | ND |
N | 208600000X | Surgeon | 8445 | ND |
NPI | 1033136676 |
---|---|
Provider Name | Bhargav M Mistry |
First Address | Fargo, ND 58102-3641 |
Second Address | Fargo, ND 58102-3641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 30/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H12220 | (02) |