Individual
DOMINIC T MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4626 KAVON AVE, BALTIMORE, MD 21206-5706
(443) 759-4006
(443) 203-2636
Mailing address
4626 KAVON AVE, BALTIMORE, MD 21206-5706
(443) 759-4006
(443) 203-2636
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/17/2019
Last updated
08/17/2019
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