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Individual

CHARLES RAY MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
25 AIRPARK CT, GREENVILLE, SC 29607-6188
(864) 546-4497
(864) 546-4506
Mailing address
PO BOX 484, EASLEY, SC 29641-0484
(864) 546-4497
(864) 546-4506

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22923
SC
208VP0000X
Pain Medicine Physician
22923
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
T71482
SC
Enumeration date
06/21/2006
Last updated
02/20/2017
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