Individual
MATTHEW PARENT MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
15 GRACELAWN RD STE 101, AUBURN, ME 04210-6347
(207) 333-4710
(207) 333-4715
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8950
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2190
ME
363AM0700X
Medical Physician Assistant
PA2190
ME
363AS0400X
Surgical Physician Assistant
Primary
PA2190
ME
Other
Enumeration date
01/14/2021
Last updated
06/03/2022
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