Mitzel, Derek James

Mitzel, Derek James is an individual health care provider with primary practice located at 18205 N 51St Ave Suite 109, Glendale AZ 85308-1490. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Mitzel, Derek James can be contacted via phone (602) 547-1400.

Contact Information

Primary practice address
18205 N 51St Ave Suite 109 Glendale AZ 85308-1490
Phone: (602) 547-1400
Fax: (602) 547-1401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207LC0200X 4296 Arizona
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 4296 Arizona

Profile Details

NPI number 1477508232
LBN Legal business name Mitzel, Derek James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2006
Last updated May 27th, 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 1477508232 NPPES
Arizona MEDICAID 116627
Arizona Other Z115507

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