Provider Demographics
NPI:1922365733
Name:DONNER, MITCHELL JAMES (MD)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:JAMES
Last Name:DONNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1365 ROCK QUARRY RD STE 202
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-5023
Mailing Address - Country:US
Mailing Address - Phone:770-771-6580
Mailing Address - Fax:770-771-6589
Practice Address - Street 1:1365 ROCK QUARRY RD STE 202
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-5023
Practice Address - Country:US
Practice Address - Phone:770-771-6580
Practice Address - Fax:770-771-6589
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA77364207LP2900X
MA1922365733207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology