Individual
DR. MITCHELL OETKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1025 W MEETING ST STE 100, LANCASTER, SC 29720-2245
(803) 285-3700
Mailing address
PO BOX 935722, ATLANTA, GA 31193-5722
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
02005308A
IN
207X00000X
Orthopaedic Surgery Physician
Primary
87761
SC
208600000X
Surgery Physician
02005308A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/01/2013
Last updated
08/02/2022
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