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NPI Code Detail

MEDICARE: SEAN PATRICK MITCHELL PA-C

MEDICARE: SEAN PATRICK MITCHELL PA-C
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
1363A00000XPhysician Assistant0110008716VA
2363A00000XPhysician Assistant

General Provider Information

NPI Number : 1861123309
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN PATRICK MITCHELL PA-C
Provider Business Mailing Address
First Line : 213 S JEFFERSON ST STE 1006
Second Line :
City : ROANOKE
State : VA
Zip : 24011-1713
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4348 ELECTRIC RD
Second Line :
City : ROANOKE
State : VA
Zip : 24018-0720
Country : US
Telephone Number : 540-769-0700
Fax Number : 540-772-8159
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2022
Last Update Date : 01/28/2026

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Directions to “ SEAN PATRICK MITCHELL PA-C” Practice Location

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