Individual
MITCHELL VINCENT MATHIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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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