MEDICARE: MARCUS BRIAN MITCHELL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	01096222A	IN
2	207L00000X	Anesthesiology Physician	D91543	MD

General Provider Information

NPI Number	:	1235662552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCUS BRIAN MITCHELL M.D.

Provider Business Mailing Address
First Line	:	6201 GREENLEIGH AVE
Second Line	:
City	:	MIDDLE RIVER
State	:	MD
Zip	:	21220-2004
Country	:	US
Telephone Number	:	410-933-0000
Fax Number	:	410-500-4266

Provider Business Practice Location Address
First Line	:	1402 E COUNTY LINE RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-0963
Country	:	US
Telephone Number	:	317-887-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2017
Last Update Date	:	01/08/2026

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