Individual
E PATRICK MITCHELL
Active
Individual
E PATRICK MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
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
Update your record
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