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General NPI Number Information
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NPI Number | 1942864590
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Entity Type | Individual
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Provider Name | MITCHELL WARREN MD
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Gender | Male
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Dates
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Enumeration Date | 04/30/2019
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Last Update Date | 07/02/2022
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Provider Practice Location Address
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Address Line | 201 E GROVER ST
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City | SHELBY
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State | NC
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Zip | 28150-3917
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Country | US
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Telephone | 330-414-7879
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Fax |
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Provider Business Mailing Address
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Address Line | 205 AUTEN ST
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City | CHARLOTTE
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State | NC
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Zip | 28208-4301
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Country | US
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Telephone | 610-945-5376
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | BP10066795
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2022-01191
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License Number State | NC
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