Provider Demographics
NPI:1790314045
Name:MITCHELL, SCOTT C II (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:C
Last Name:MITCHELL
Suffix:II
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 1:160-7 CEDAR BREEZE SOUTH
Mailing Address - Street 2:
Mailing Address - City:GLENBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04401
Mailing Address - Country:US
Mailing Address - Phone:207-478-3088
Mailing Address - Fax:
Practice Address - Street 1:INDIANA UNIVERSITY SCHOOL OF MEDICINE DEPT OF NEUROSURG
Practice Address - Street 2:355 W. 16TH ST, GH 5100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-963-8145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty