Individual
DR. MARK CHANDLER MITCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2648 LEE AVENUE, SANFORD, NC 27332-5950
(919) 775-5221
(919) 775-7655
Mailing address
428 CHANDLER GRANT DR, CARY, NC 27519-8838
(336) 524-6604
(336) 524-6579
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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