Provider Demographics
NPI:1669855466
Name:MITCHELL, ANDREW B (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:B
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 MANNING DR SW STE D101
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4341
Mailing Address - Country:US
Mailing Address - Phone:256-533-6070
Mailing Address - Fax:256-533-4937
Practice Address - Street 1:115 MANNING DR SW STE D101
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4341
Practice Address - Country:US
Practice Address - Phone:256-533-6070
Practice Address - Fax:256-533-4937
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7485208600000X
ALMD.44465208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery