Organization
MITCHELL INTERNAL MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DYATRA B MITCHELL MD (OWNER)
(513) 336-9101
Entity
Organization
Contact information
Practice address
4834 SOCIALVILLE FOSTER RD, SUITE 10, MASON, OH 45040-6826
(513) 336-9101
Mailing address
PO BOX 643766, CINCINNATI, OH 45264-3766
(513) 336-9101
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2061165
—
OH
Enumeration date
07/05/2006
Last updated
04/06/2010
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