Individual
DR. BRUCE LEROY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2208
(404) 686-6730
Mailing address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2208
(404) 686-6730
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME70743
FL
208M00000X
Hospitalist Physician
Primary
031292
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110145938
RAILROAD MEDICARE
FL
05
—
268585000
—
FL
01
—
32760
BLUECROSS/BLUESHIELD
DC
Enumeration date
10/15/2005
Last updated
09/17/2015
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