Healthcare Provider Details

I. General information

NPI: 1467456921
Provider Name (Legal Business Name): JOHN E MITCHELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2005
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 HERLONG AVE S
ROCK HILL SC
29732-1158
US

IV. Provider business mailing address

640 S STATE ST
DOVER DE
19901-3530
US

V. Phone/Fax

Practice location:
  • Phone: 803-329-1234
  • Fax: 803-328-1785
Mailing address:
  • Phone: 302-674-4070
  • Fax: 302-672-2315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number96218
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberMD450156
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC1-0026239
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: