MEDICARE: MR. MICHAEL ALEXANDER MITCHELL P.A.

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	363AM0700X	Medical Physician Assistant	1061312
2	363A00000X	Physician Assistant	0010-16021	NC

General Provider Information

NPI Number	:	1982674487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL ALEXANDER MITCHELL P.A.

Provider Business Mailing Address
First Line	:	501 DISCOVERY DR
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-3832
Country	:	US
Telephone Number	:	757-547-5145
Fax Number	:	757-312-0216

Provider Business Practice Location Address
First Line	:	150 BURNETTS WAY
Second Line	:	STE. 100
City	:	SUFFOLK
State	:	VA
Zip	:	23434-8168
Country	:	US
Telephone Number	:	757-547-5145
Fax Number	:	757-539-7488

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	01/06/2026

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