Provider Demographics
NPI:1538328349
Name:MITCHELL, RICHARD F (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:F
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 EXCELSIOR BLVD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-4744
Mailing Address - Country:US
Mailing Address - Phone:952-993-7711
Mailing Address - Fax:
Practice Address - Street 1:6600 EXCELSIOR BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-4744
Practice Address - Country:US
Practice Address - Phone:952-993-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN49812207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine