MR. Miteshkumar N Modi, PA-C

NPI #1891829222 in Marion, Illinois

Provider Information

NPI Number
1891829222
Entity Type
Individual
Name
MR. Miteshkumar N Modi, PA-C
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Physician Assistant
Credential
PA-C
Enumeration Date
Mar 15, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
2401 W MAIN ST
City
Marion
ZIP Code
62959-1188
Phone
(618) 997-5311

Specialties & Taxonomy Codes

Specialty
Physician Assistant

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