Individual
MARK J MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3003 W GOOD HOPE ROAD, MILWAUKEE, WI 53209
(414) 352-3100
(414) 247-4590
Mailing address
3003 W GOOD HOPE ROAD, MILWAUKEE, WI 53209
(414) 352-3100
(414) 247-4590
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
21051
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30249000
—
WI
Enumeration date
07/07/2006
Last updated
07/13/2007
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