Provider Demographics
NPI:1730132473
Name:MITCHELL, MICHAEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:CHILDREN'S HOSPITAL OF WISCONSIN
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3518
Mailing Address - Country:US
Mailing Address - Phone:414-266-2491
Mailing Address - Fax:414-266-2075
Practice Address - Street 1:CHILDREN'S HOSPITAL OF WISCONSIN
Practice Address - Street 2:9000 WEST WISCONSIN AVENUE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:414-266-2491
Practice Address - Fax:414-266-2075
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2024-03-04
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Provider Licenses
StateLicense IDTaxonomies
WI49005208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34835100Medicaid
WI34835100Medicaid