Kamrudin Mithani, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D32609 Issued in MD

Practice address

1106 Revolution St
Havre de Grace, MD 21078-3721

Phone

(410) 939-1050

Fax

(410) 939-2010

NPI assigned

Sep 27, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263686400000",
    "number": "1285620922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 REVOLUTION ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783721",
            "telephone_number": "410-939-1050",
            "fax_number": "410-939-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 REVOLUTION ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783721",
            "telephone_number": "410-939-1050",
            "fax_number": "410-939-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITHANI",
        "first_name": "KAMRUDIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2010-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D32609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380121700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "5973",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gianni B Migliaccio, PA-C
• Surendra Kumar Milak, M.D., F.A.C.E.P.
• Gloria Miller, MS, CCC-SLP
• Katrina E Millsape, NURSE PRACTITIONER
• Jasper Mislak
• Monarch Behavioral Therapy Bii, LLC
• Lisa Montgomery
• Alice McCarty Moore, APN-BC
• Lydia Moore, LCPC
• Regina Morgen

• Family Medicine Physician in Havre de Grace, MD
• Providers in Havre de Grace, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.