Provider Demographics
NPI:1043537020
Name:MITCHELL, EMILY A (DO)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:A
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2968
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46515-2968
Mailing Address - Country:US
Mailing Address - Phone:574-296-3200
Mailing Address - Fax:574-296-3392
Practice Address - Street 1:303 S NAPPANEE ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-2066
Practice Address - Country:US
Practice Address - Phone:574-296-3200
Practice Address - Fax:574-296-3392
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101018742208600000X
IN02004694A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
INPENDINGMedicaid
INPENDINGOtherRAILROAD MEDICARE PIN
MI1043537020Medicaid
INPENDINGMedicare PIN