Individual
RICHARD ANDREW MITSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1640 NEIL AVE, ROOM 438, COLUMBUS, OH 43201
(614) 292-5766
(614) 688-3440
Mailing address
PO BOX 130, 13311 EAST BUCK RUN RD, ROCKBRIDGE, OH 43149-0130
(740) 385-6342
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
OHIO3533704
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0321539
—
OH
Enumeration date
03/30/2007
Last updated
07/08/2007
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