Individual
E PATRICK MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1 WILLIAM CARLS DR, RSC, COMMERCE TOWNSHIP, MI 48382-2201
(248) 937-4947
(248) 937-5150
Mailing address
1 WILLIAM CARLS DR, RSC, COMMERCE TOWNSHIP, MI 48382-2201
(248) 937-4947
(248) 937-5150
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5101007550
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132620
CARE CHOICES/PREFERRED CH
MI
01
—
2056300195
BCBSM PIN #
MI
05
—
3515784 TYPE 11
—
MI
01
—
4274992
AETNA
MI
01
—
5101007550
MI STATE LICENSE
MI
01
—
5606110001
ADMINISTAR FED DME RSC
MI
01
—
5606110003
ADMINISTAR FED DME HARTLAND
MI
01
—
C6758
MCARE
MI
Enumeration date
11/03/2005
Last updated
05/14/2008
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