Mitchell, Mark Edward
Mitchell, Mark Edward is an individual health care provider with primary practice located at 2960 Tongass Avenue , Ketchikan AK 99901-5742. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mitchell, Mark Edward can be contacted via phone (907) 228-4900.Contact Information
Primary practice address
2960 Tongass Avenue
Ketchikan AK 99901-5742
Phone: (907) 228-4900
Fax: (800) 852-3264
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2681761205 | Utah |
Profile Details
| NPI number | 1689634479 |
|---|---|
| LBN Legal business name | Mitchell, Mark Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Jul 1st, 2016 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689634479 | NPPES |
| New Mexico | MEDICAID | 52588084 | |
| New Mexico | MEDICAID | 82071365 | |
| New Mexico | MEDICAID | D0289 | |
| New Mexico | MEDICAID | 314804 |
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