Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | H0063949 | MD |
N | 207Q00000X | Family Doctor | H0063949 | MD |
NPI | 1518999424 |
---|---|
Provider Name | Dr. Christine A Mitchell |
First Address | Los Alamos, NM 87544-1857 |
Second Address | Baltimore, MD 21210-2800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 09/04/2018 |