Healthcare Provider Details

I. General information

NPI: 1154340602
Provider Name (Legal Business Name): MAX MITCHELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 N HIGH ST STE 260
DENVER CO
80205-5575
US

IV. Provider business mailing address

2055 N HIGH ST STE 260
DENVER CO
80205-5575
US

V. Phone/Fax

Practice location:
  • Phone: 720-475-8730
  • Fax: 303-832-7297
Mailing address:
  • Phone: 720-475-8730
  • Fax: 303-832-7297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number31202
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: