Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 0101242262 | VA |
Y | 111NI0900X | Internist | 0101242262 | VA |
N | 207R00000X | Internist | 2007-00907 | NC |
N | 111NI0900X | Internist | 2007-00907 | NC |
NPI | 1003012451 |
---|---|
Provider Name | Ranjana N Mitra |
First Address | Norfolk, VA 23502-3920 |
Second Address | Norfolk, VA 23502-3920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2007 |
Last Update Date | 16/10/2019 |