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NPI Code Detail

MEDICARE: DR. BRUCE LEROY MITCHELL M.D.

MEDICARE:  DR. BRUCE LEROY MITCHELL  M.D.
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
1207R00000XInternal Medicine PhysicianME70743FL
2208M00000XHospitalist Physician031292GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2110145938OTHERFLRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
132760OTHERDCBLUECROSS/BLUESHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245229970
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRUCE LEROY MITCHELL M.D.
Provider Business Mailing Address
First Line : 550 PEACHTREE ST NE
Second Line :
City : ATLANTA
State : GA
Zip : 30308-2208
Country : US
Telephone Number : 404-686-6730
Fax Number :
Provider Business Practice Location Address
First Line : 550 PEACHTREE ST NE
Second Line :
City : ATLANTA
State : GA
Zip : 30308-2208
Country : US
Telephone Number : 404-686-6730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2005
Last Update Date : 09/17/2015

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Directions to “ DR. BRUCE LEROY MITCHELL M.D.” Practice Location

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