Individual
MITCHELL JOSEPH ISAAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 SINGLETON RIDGE RD, CONWAY, SC 29526-9154
(843) 347-7300
(843) 347-8459
Mailing address
300 SINGLETON RIDGE RD, ATTN PNS CREDENTIALING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
41136
SC
207Y00000X
Otolaryngology Physician
LL41136
SC
Other
Enumeration date
06/01/2017
Last updated
08/01/2022
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