Individual
DONALD A MITZELFELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036088541
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036088541
—
IL
01
—
09015685
BLUE CROSS BLUE SHIELD
IL
01
—
P00282243
RAIL ROAD MEDICARE PIN
IL
Enumeration date
05/17/2006
Last updated
12/31/2019
Update your record
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