Provider Demographics
NPI:1699183525
Name:GAIL, MITCHELL (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:
Last Name:GAIL
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9609 MEDICAL CENTER DR
Mailing Address - Street 2:ROOM 7E138
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3330
Mailing Address - Country:US
Mailing Address - Phone:240-276-7315
Mailing Address - Fax:
Practice Address - Street 1:9609 MEDICAL CENTER DR
Practice Address - Street 2:ROOM 7E138
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3330
Practice Address - Country:US
Practice Address - Phone:240-276-7315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00346941744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study