Provider Demographics
NPI:1629504873
Name:MISHRA, TUSHAR (MD/MBBS)
Entity type:Individual
Prefix:
First Name:TUSHAR
Middle Name:
Last Name:MISHRA
Suffix:
Gender:M
Credentials:MD/MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 PRINCETON AVE SW STE 707
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1309
Mailing Address - Country:US
Mailing Address - Phone:205-780-4330
Mailing Address - Fax:205-780-7775
Practice Address - Street 1:801 PRINCETON AVE SW STE 707
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1395
Practice Address - Country:US
Practice Address - Phone:205-780-4330
Practice Address - Fax:205-780-7775
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL51021207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease