Basic Information
| Provider Information | |||||||||
| NPI: | 1811951775 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MITHANI | ||||||||
| FirstName: | HASMUKH | ||||||||
| MiddleName: | AMRITLAL | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2817 REILLY RD | ||||||||
| Address2: | WOMACK ARMY MEDICAL CENTER MEXC-COD CREDENTIALS | ||||||||
| City: | FORT BRAGG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9109078922 | ||||||||
| FaxNumber: | 9109076069 | ||||||||
| Practice Location | |||||||||
| Address1: | 2817 REILLY RD | ||||||||
| Address2: | WAMC OPTHAMOLOGY SECTION | ||||||||
| City: | FT BRAGG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9109076001 | ||||||||
| FaxNumber: | 9109078614 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 22658 | NC | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.