MEDICARE: DR. MITCHELL JAMES WHARTON CRNP, CNS

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	363LF0000X	Family Nurse Practitioner	500022614	DC

General Provider Information

NPI Number	:	1770749848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL JAMES WHARTON CRNP, CNS

Provider Business Mailing Address
First Line	:	1816 12TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-4422
Country	:	US
Telephone Number	:	202-446-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1816 12TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-4422
Country	:	US
Telephone Number	:	202-446-1100
Fax Number	:

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

Provider Enumeration Date	:	07/29/2008
Last Update Date	:	11/03/2025

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