Individual
DR. JEREMY MITNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4001
Mailing address
4650 WASHINGTON BLVD APT 811, ARLINGTON, VA 22201-5745
(646) 912-5172
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0116037983
VA
208600000X
Surgery Physician
Primary
116037983
VA
Other
Enumeration date
06/12/2023
Last updated
03/27/2024
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