Organization
MITCHELL HEALTHCARE ASSOCIATES
Active
Other names
Kenneth Mitchell
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA H STUART (MANAGER)
(313) 831-9264
Entity
Organization
Contact information
Practice address
3800 WOODWARD AVE, STE 812, DETROIT, MI 48201-2061
(313) 831-9269
(313) 831-9274
Mailing address
3800 WOODWARD AVE, STE 812, DETROIT, MI 48201-2061
(313) 831-9269
(313) 831-9274
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901001869
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3507405
MOLINA
—
05
—
3507405
—
MI
01
—
KM001869
BCBSM
MI
Enumeration date
10/21/2005
Last updated
08/22/2020
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