Individual
KATHLEEN F MITCHELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
485 ARSENAL ST, WATERTOWN, MA 02472-5091
(617) 972-5100
(671) 972-5439
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8053
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
58561
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015140
NEIGHBORHOOD HEALTH
MA
01
—
058561
TUFTS
MA
05
—
3190633
—
MA
01
—
J06691
BLUE CROSS
MA
01
—
PP287
HARVARD PILGRIM
MA
Enumeration date
01/17/2006
Last updated
07/08/2007
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