Maibam, Amita
Maibam, Amita is an sole proprietor health care provider with primary practice located at 1542 Medical Park Cir , Tupelo MS 38801-6560. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Maibam, Amita can be contacted via phone (662) 844-4711.Contact Information
Primary practice address
1542 Medical Park Cir
Tupelo MS 38801-6560
Phone: (662) 844-4711
Fax: (662) 844-9619
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 26530 | Mississippi |
Profile Details
| NPI number | 1487020806 |
|---|---|
| LBN Legal business name | Maibam, Amita |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 19th, 2015 |
| Last updated | Aug 12th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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