Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 793990 | OH |
N | 111NI0900X | Internist | 793990 | OH |
Y | 207RN0300X | Nephrologist | 207RN0300X | RI |
NPI | 1033466560 |
---|---|
Provider Name | Dr. Amol Mittal |
First Address | Providence, RI 02903-4923 |
Second Address | Providence, RI 02903-4923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2012 |
Last Update Date | 16/03/2016 |