Healthcare Provider Details

I. General information

NPI: 1336554948
Provider Name (Legal Business Name): CATHERINE MITCHEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S PLUM ST
VERMILLION SD
57069-3306
US

IV. Provider business mailing address

101 S PLUM ST
VERMILLION SD
57069-3306
US

V. Phone/Fax

Practice location:
  • Phone: 605-624-8643
  • Fax:
Mailing address:
  • Phone: 605-624-8643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10440
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: