MEDICARE: E PATRICK MITCHELL D.O.

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	207X00000X	Orthopaedic Surgery Physician	5101007550	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5101007550	OTHER	MI	MI STATE LICENSE
2	132620	OTHER	MI	CARE CHOICES/PREFERRED CH
3	5606110003	OTHER	MI	ADMINISTAR FED DME HARTLAND
4	C6758	OTHER	MI	MCARE
5	2056300195	OTHER	MI	BCBSM PIN #
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	4274992	OTHER	MI	AETNA
8	5606110001	OTHER	MI	ADMINISTAR FED DME RSC

General Provider Information

NPI Number	:	1447241864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	E PATRICK MITCHELL D.O.

Provider Business Mailing Address
First Line	:	1 WILLIAM CARLS DR
Second Line	:	RSC
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48382-2201
Country	:	US
Telephone Number	:	248-937-4947
Fax Number	:	248-937-5150

Provider Business Practice Location Address
First Line	:	1 WILLIAM CARLS DR
Second Line	:	RSC
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48382-2201
Country	:	US
Telephone Number	:	248-937-4947
Fax Number	:	248-937-5150

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

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	05/14/2008

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Directions to “ E PATRICK MITCHELL D.O.” Practice Location

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