Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 5101017492 | MI |
Y | 207P00000X | Emergency Physician | N7686 | TX |
NPI | 1013105543 |
---|---|
Provider Name | Dr. Mitra Margaret Campbell |
First Address | Austin, TX 78704-6218 |
Second Address | Kyle, TX 78640-6112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2007 |
Last Update Date | 03/03/2016 |