MEDICARE: WILLIAM MITCHELL MD

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	207T00000X	Neurological Surgery Physician	25MA07386100	NJ

General Provider Information

NPI Number	:	1548260722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM MITCHELL MD

Provider Business Mailing Address
First Line	:	PO BOX 270
Second Line	:
City	:	COLLINGSWOOD
State	:	NJ
Zip	:	08108-0270
Country	:	US
Telephone Number	:	856-372-9422
Fax Number	:	856-409-0393

Provider Business Practice Location Address
First Line	:	851 ROUTE 73 N STE D
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-1275
Country	:	US
Telephone Number	:	856-372-9422
Fax Number	:

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	11/30/2021

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