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Contact Information

HIMANSHU MITTAL, MD
2620 N. WESTWOOD BLVD
POPLAR BLUFF, MO63901
 Phone: 573-727-2640
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for HIMANSHU MITTAL · (Male)

NPI Number 1366682239
Status Active
Credentials MD
Entity Individual
Enumeration date 03/04/2009
Last updated 01/18/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • MO License # 2011021601
  • PA License # MT192795
Hospital affiliation(s)
  • SSM ST JOSEPH HOSPITAL WEST - (Acute Care)
    100 MEDICAL PLAZA
    LAKE SAINT LOUIS, MO 63367
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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