Individual
DR. ALAN H MITNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5400 OLD COURT RD, SUITE 105, RANDALLSTOWN, MD 21133-5100
(410) 922-1133
(410) 922-9740
Mailing address
3408 ENGLEMEADE RD, PIKESVILLE, MD 21208-1601
(410) 484-1416
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0007985
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026021500
—
MD
Enumeration date
06/16/2006
Last updated
07/09/2007
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