MEDICARE: DR. DOUGLAS MITCHELL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	D39037	MD

General Provider Information

NPI Number	:	1083614481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS MITCHELL MD

Provider Business Mailing Address
First Line	:	7250 PARKWAY DR
Second Line	:	STE 500
City	:	HANOVER
State	:	MD
Zip	:	21076-1343
Country	:	US
Telephone Number	:	410-216-6481
Fax Number	:	410-280-6515

Provider Business Practice Location Address
First Line	:	6934 AVIATION BLVD
Second Line	:	SUITE B
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-2593
Country	:	US
Telephone Number	:	443-949-0814
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	10/02/2017

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