MEDICARE: MITCHELL PAETH

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	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian

General Provider Information

NPI Number	:	1922939974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MITCHELL PAETH

Provider Business Mailing Address
First Line	:	119 E COLLEGE AVE
Second Line	:
City	:	BROWNSBURG
State	:	IN
Zip	:	46112-1206
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5255 E STOP 11 RD STE 440
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46237-6341
Country	:	US
Telephone Number	:	317-528-7525
Fax Number	:

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

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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Directions to “ MITCHELL PAETH ” Practice Location

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