Mistry, Sima Gopal
Mistry, Sima Gopal is an individual health care provider with primary practice located at 11603 State Ave Ste G Providence Medical Group Marysville Clinic, Marysville WA 98271-8465. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Mistry, Sima Gopal can be contacted via phone (360) 658-6800.Contact Information
Primary practice address
11603 State Ave Ste G Providence Medical Group Marysville Clinic
Marysville WA 98271-8465
Phone: (360) 658-6800
Fax: (360) 658-6819
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 60403767 | Washington |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 60403767 | Washington |
Profile Details
| NPI number | 1760625552 |
|---|---|
| LBN Legal business name | Mistry, Sima Gopal |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 9th, 2009 |
| Last updated | Feb 18th, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760625552 | NPPES |
| Louisiana | MEDICAID | 1926710 | |
| Louisiana | Other | MD60403767 |
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