Individual
MATTHEW J. MITSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
SUITE 6, 1821 OLD DONATION PARKWAY, VIRGINIA BCH, VA 23454-3033
(757) 496-4864
(757) 496-4942
Mailing address
SUITE 6, 1821 OLD DONATION PARKWAY, VIRGINIA BCH, VA 23454-3033
(757) 496-4864
(757) 496-4942
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101052465
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0499149
GHI
VA
01
—
142942XX
PREFERRED CARE
VA
01
—
3078121
CIGNA PPO
VA
01
—
333299
MAMSI
VA
01
—
380172
ANTHEM
VA
01
—
44740849
MULTI-PLAN PPO
VA
01
—
54-1816313
VA. HEALTH NETWORK
VA
01
—
600212807
CIGNA
VA
01
—
61240
OPTIMA
VA
05
—
6900925
—
VA
01
—
843259
FIRST HEALTH
VA
Enumeration date
08/09/2006
Last updated
07/30/2008
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