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General NPI Number Information
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NPI Number | 1831370857
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Entity Type | Organization
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Legal Business Name | CARL I. MITCHELL, MD, PA
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 1 WINDSOR CV STE 301
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City | COLUMBIA
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State | SC
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Zip | 29223-1833
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Country | US
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Telephone | 803-736-4050
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Fax | 803-736-4083
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Provider Business Mailing Address
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Address Line | 1 WINDSOR CV STE 301
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City | COLUMBIA
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State | SC
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Zip | 29223-1833
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Country | US
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Telephone | 803-736-4050
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Fax | 803-736-4083
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CARL ISSAC MITCHELL
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Credential | M.D.
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Telephone | 803-736-4050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 8063
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License Number State | SC
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