Individual
LAWRENCE C. MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 6777 WEST MAPLE ROAD, WEST BLOOMFIELD, MI 48323
(248) 661-6450
(248) 661-6649
Mailing address
2520 S TELEGRAPH ROAD, HENRY FORD HEALTH SYSTEM, BLOOMFIELD HILLS, MI 48330
(248) 451-6001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
039076
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137335810
—
MI
01
—
700H262220
BLUE CROSS-BLUE CROSS
—
01
—
LM039076
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
12/01/2006
Last updated
08/13/2012
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