Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 35-084888 | OH |
N | 207SG0201X | Clinical Genetics (M.D.) | 35.84888 | OH |
NPI | 1710903687 |
---|---|
Provider Name | Anna Mitchell |
First Address | Euclid, OH 44117-1714 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 21/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000224399 | UNISON (01) | OH |
000000343700 | ANTHEM (01) | OH |
000000529593 | ANTHEM (01) | OH |
1018173300001 | (05) | PA |
2512865 | (05) | OH |
363851 | WELLCARE (01) | OH |
7057443 | AETNA (01) | OH |
745995 | BUCKEYE (01) | OH |
H60858 | (02) | OH |