Individual
MARK ANTHONY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
186 KIMEL PARK DR, WINSTON SALEM, NC 27103-6946
(336) 277-2000
(336) 277-2050
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 277-2000
(336) 277-2050
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
9800640
NC
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
9800640
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11372
BCBS ID#
NC
01
—
1285682310
WSCA GRP NPI #
NC
05
—
1881660157
—
VA
01
—
23662
PARTNERS ID#
NC
05
—
8911372
—
NC
Enumeration date
02/27/2006
Last updated
03/07/2023
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