Provider Demographics
NPI:1639252109
Name:MITCHELL, ROBERT E III (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:MITCHELL
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7605 FOREST AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4940
Mailing Address - Country:US
Mailing Address - Phone:804-282-3114
Mailing Address - Fax:804-285-9723
Practice Address - Street 1:7605 FOREST AVE STE 211
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4940
Practice Address - Country:US
Practice Address - Phone:804-282-3114
Practice Address - Fax:804-285-9723
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2008-02-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101040964207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101040964OtherSTATE LICENSE
217009OtherANTHEM PROVIDER NUMBER
1023106390OtherGROUP NPI
B10289Medicare UPIN
1023106390OtherGROUP NPI