IndividualActive
Amita Maibam, M.D.
NPI 1487020806 · Nephrology Physician · Tupelo, MS
Provider details
- NPI number
- 1487020806
- Entity type
- Individual
- Primary specialty
- Nephrology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- Yes
- License
- 26530 (MS)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1542 Medical Park Cir
Tupelo, MS 38801-6560
Phone: (662) 844-4711
Fax: (662) 844-9619
Approximate (ZIP-level) locationGet directions
Mailing address
1542 Medical Park Cir
Tupelo, MS 38801-6560
Additional practice locations (1)
- University of Kentucky 800 Rose StLexington, KY 40536-0293Phone: (859) 323-2636
Registry dates
- Enumerated
- 2015-08-19
- Last updated
- 2019-08-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.