Individual
DR. MARK CHANDLER MITCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1270
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093N1
BCBSNC
NC
05
—
89093N1
—
NC
Enumeration date
06/05/2006
Last updated
09/24/2019
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