Provider Demographics
NPI:1891727897
Name:MITTER, NANHI (MD)
Entity Type:Individual
Prefix:DR
First Name:NANHI
Middle Name:
Last Name:MITTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 ORLEANS STREET
Mailing Address - Street 2:ZAYED 6208
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287
Mailing Address - Country:US
Mailing Address - Phone:410-955-7519
Mailing Address - Fax:410-955-0994
Practice Address - Street 1:1800 ORLEANS STREET
Practice Address - Street 2:ZAYED 6208
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287
Practice Address - Country:US
Practice Address - Phone:410-955-7519
Practice Address - Fax:410-955-0994
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-116121207L00000X
MDD67629207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD019483200Medicaid
IL363117700OtherGROUP TAX ID NUMBER