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Individual

MITCHELL VINCENT MATHIS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10630 LITTLE PATUXENT PARKWAY, SUITE 209, COLUMBIA, MD 21044
(410) 740-8066
(410) 740-8068
Mailing address
10630 LITTLE PATUXENT PARKWAY, SUITE 209, COLUMBIA, MD 21044
(410) 740-8066
(410) 740-8068

Taxonomy

Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
D0051608
MD
2084P0805X
Geriatric Psychiatry Physician
Primary
D0051608
MD

Other

Enumeration date
12/04/2007
Last updated
04/05/2012
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