Individual
MICHAEL J. MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF CLINICAL PATHOLOGY, WORCESTER, MA 01655-0002
(774) 442-9271
(774) 442-9604
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
58562
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3037061
—
MA
Enumeration date
12/05/2005
Last updated
10/28/2020
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