Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME74819 | FL |
N | 111NI0900X | Internist | ME74819 | FL |
Y | 207RH0002X | Hospice and Palliative Medicine | 075473 | GA |
NPI | 1326156563 |
---|---|
Provider Name | Dr. Paul G Mitchell |
First Address | Atlanta, GA 30342-2163 |
Second Address | Atlanta, GA 30342-2163 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2006 |
Last Update Date | 03/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003175049A | (05) | GA |
003175049B | (05) | GA |
202I191595 | (02) | GA |
B43167 | (02) | FL |
ME74819 | MEDICAL LICENSE NUMBER (01) | FL |