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Individual

SALLY E MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 767-3318
Mailing address
PO BOX 64358, BALTIMORE, MD 21264-4358
(410) 550-2948

Taxonomy

Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
D26578
MD
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME151631
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
071261200
MD
Enumeration date
05/12/2006
Last updated
10/11/2022
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