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1104976380
MEHTAB MIZAN
URBANA, IL
NPI
1104976380
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: IL 036098942)
Enumeration Date
2007-01-11
Last Update Date
2014-05-06
Business Address
-- MEHTAB MIZAN MD
611 W PARK ST
URBANA, IL 61801-2500
Phone number: 217-383-3129
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Mailing Address
-- MEHTAB MIZAN MD
611 W PARK ST BWPC
URBANA, IL 61801-2529
Phone number: 217-383-6792
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