Provider Demographics
NPI:1225295108
Name:MOOKHERJEE, DISHA (MD)
Entity Type:Individual
Prefix:DR
First Name:DISHA
Middle Name:
Last Name:MOOKHERJEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1001 E SUPERIOR ST
Mailing Address - Street 2:STE. L201
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-2207
Mailing Address - Country:US
Mailing Address - Phone:218-249-3057
Mailing Address - Fax:218-249-3091
Practice Address - Street 1:1001 E SUPERIOR ST
Practice Address - Street 2:STE. L201
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2207
Practice Address - Country:US
Practice Address - Phone:218-249-3057
Practice Address - Fax:218-249-3091
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN52008207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease