Individual
DR. DANIEL M MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1711 S STEPHENSON AVE, SUITE 300, IRON MOUNTAIN, MI 49801-3650
(906) 774-1633
(906) 774-4451
Mailing address
1711 S STEPHENSON AVE, SUITE 300, IRON MOUNTAIN, MI 49801-3650
(906) 774-1633
(906) 774-4451
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301042600
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01007242
PREFERRED ONE
—
01
—
080055774
RAILROAD MEDICARE
—
01
—
080220008
BLUE CROSS BLUE SHIELD
MI
05
—
101686648
—
MI
05
—
30333700
—
WI
Enumeration date
08/12/2005
Last updated
09/29/2010
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