Provider Demographics
NPI:1174597942
Name:MISRA, DEVI P (MD)
Entity type:Individual
Prefix:DR
First Name:DEVI
Middle Name:P
Last Name:MISRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WHITESPORT DR SW
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6452
Mailing Address - Country:US
Mailing Address - Phone:256-880-0455
Mailing Address - Fax:256-882-6382
Practice Address - Street 1:400 WHITESPORT DR SW
Practice Address - Street 2:SUITE 103
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6452
Practice Address - Country:US
Practice Address - Phone:256-880-0455
Practice Address - Fax:256-882-6382
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9102207RP1001X, 208M00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL411013507OtherMEDICARE RAILROAD RETIREM
AL000004729Medicaid
AL510-04729OtherBCBS
AL411013507OtherMEDICARE RAILROAD RETIREM
ALC75989Medicare UPIN