Individual
DR. JOHN DANIEL MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Mailing address
15 CHALK ST, CAMBRIDGE, MA 02139-4402
(617) 864-2706
(617) 864-2706
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
20001214
NC
207L00000X
Anesthesiology Physician
220476
MA
207L00000X
Anesthesiology Physician
Primary
4301507178
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200001214
NC MEDICAL LICENSE
NC
01
—
220476
MA MEDICAL LICENSE
MA
Enumeration date
10/14/2005
Last updated
06/17/2022
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