Mitra, Avick G

Mitra, Avick G is an individual health care provider with primary practice located at 1025 Morehead Medical Dr Suite 500, 5Th Floor, Charlotte NC 28204-2963. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine. Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine is his primary health care specialty. Mitra, Avick G can be contacted via phone (704) 355-3149.

Contact Information

Primary practice address
1025 Morehead Medical Dr Suite 500, 5Th Floor Charlotte NC 28204-2963
Phone: (704) 355-3149
Fax: (704) 355-5891
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 32018 North Carolina
Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine 207VM0101X 32018 North Carolina

Profile Details

NPI number 1396750857
LBN Legal business name Mitra, Avick G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2006
Last updated May 8th, 2014 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1396750857 NPPES
North Carolina MEDICAID 1396750857
North Carolina MEDICAID 8959819
North Carolina MEDICAID N32018
North Carolina Other 59819

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