Durham, Mitchell

Durham, Mitchell is an individual health care provider with primary practice located at 311-4E Judges Road , Wilmington NC 28405-3655. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Durham, Mitchell can be contacted via phone (910) 791-6767.

Contact Information

Primary practice address
311-4E Judges Road Wilmington NC 28405-3655
Phone: (910) 791-6767
Fax: (910) 791-6890
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 4175 North Carolina
Behavioral Health & Social Service Providers / Psychologist 103T00000X

Profile Details

NPI number 1154372563
LBN Legal business name Durham, Mitchell
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Aug 8th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154372563 NPPES
North Carolina MEDICAID 6001347

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