Provider Demographics
NPI:1558645069
Name:MITCHELL, GARY ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:ALAN
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3222 SHELLERS BND
Mailing Address - Street 2:#214
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-3224
Mailing Address - Country:US
Mailing Address - Phone:814-238-4948
Mailing Address - Fax:814-238-4948
Practice Address - Street 1:3222 SHELLERS BND
Practice Address - Street 2:#214
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-3224
Practice Address - Country:US
Practice Address - Phone:814-238-4948
Practice Address - Fax:814-238-4948
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01022925A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine