Provider Demographics
NPI:1205814225
Name:MARKINS, MITCHEL (CRNA)
Entity Type:Individual
Prefix:
First Name:MITCHEL
Middle Name:
Last Name:MARKINS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 CHARMUTH RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-5830
Mailing Address - Country:US
Mailing Address - Phone:410-832-5775
Mailing Address - Fax:
Practice Address - Street 1:1533 CHARMUTH RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-5830
Practice Address - Country:US
Practice Address - Phone:410-832-5775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR138038367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD144534Medicare PIN
MDKQ83N185Medicare PIN