Individual
MS. CONNIE L MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5525 GREENWAY ST, UNIT B-2, DETROIT, MI 48204-2112
(313) 701-1187
(313) 931-9113
Mailing address
5525 GREENWAY ST, UNIT B-2, DETROIT, MI 48204-2112
(313) 701-1187
(313) 931-9113
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4301056553
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4706980
—
MI
Enumeration date
08/30/2006
Last updated
02/08/2011
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