Individual
DR. FREDDIE LAMONT MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
926
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09625
BCBS
NC
05
—
7909625
—
NC
01
—
DA 3706
MEDICARE RAILROAD
NC
Enumeration date
06/10/2005
Last updated
08/16/2011
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