Individual
MITCHELL T PACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
5101010036
MI
2085R0202X
Diagnostic Radiology Physician
Primary
5101010036
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MP010036
CHAMPUS-CHAMPUS
—
Enumeration date
12/01/2006
Last updated
09/11/2025
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