Provider Demographics
NPI:1326115650
Name:MISTRI, KAMLESH KRISHNA (PA-C)
Entity Type:Individual
Prefix:MR
First Name:KAMLESH
Middle Name:KRISHNA
Last Name:MISTRI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 SHILOH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-7856
Mailing Address - Country:US
Mailing Address - Phone:828-495-4445
Mailing Address - Fax:828-495-4449
Practice Address - Street 1:1232 SHILOH CHURCH RD
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-7856
Practice Address - Country:US
Practice Address - Phone:828-495-4445
Practice Address - Fax:828-495-4449
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical