Individual
DR. MICHAEL J MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3112 CASEY ST, LORIS, SC 29569-2857
(843) 716-8940
(843) 716-9760
Mailing address
506 E CHEVES ST STE 202, FLORENCE, SC 29506-2616
(843) 716-8940
(843) 716-9760
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
1918411
NY
208600000X
Surgery Physician
Primary
89809
SC
2086S0129X
Vascular Surgery Physician
1918411
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00524182003
BLUE SHIELD/BLUE CROSS
—
05
—
01669992
—
NY
01
—
0198192
GHI
—
01
—
1708059
INDEPENDENT HEALTH
—
01
—
203107077
UNITED HEALTHCARE
—
01
—
G27040
MEDICARE RAILROAD
—
Enumeration date
10/21/2005
Last updated
08/29/2023
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