Imm, Mitchell Dongjun

Imm, Mitchell Dongjun is an individual health care provider with primary practice located at 10647 Bramblecrest Dr , Austin TX 78726-1906. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine is his primary health care specialty. Imm, Mitchell Dongjun can be contacted via phone (512) 906-1974.

Contact Information

Primary practice address
10647 Bramblecrest Dr Austin TX 78726-1906
Phone: (512) 906-1974
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 200200707 North Carolina
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 200200707 North Carolina

Profile Details

NPI number 1790731230
LBN Legal business name Imm, Mitchell Dongjun
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Sep 2nd, 2008 - about 16 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 1790731230 NPPES
North Carolina MEDICAID 89131UT
North Carolina Other 131UT
North Carolina Other 7355461
North Carolina Other D8866

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