Provider Demographics
NPI:1205949617
Name:MITCHELL, SUSAN L (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:L
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:142 HILLCREST ROAD
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492
Mailing Address - Country:US
Mailing Address - Phone:781-455-6624
Mailing Address - Fax:617-363-8626
Practice Address - Street 1:1200 CENTRE ST
Practice Address - Street 2:HEBREW REHABILITATION CENTER FOR AGED
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131
Practice Address - Country:US
Practice Address - Phone:617-363-8626
Practice Address - Fax:617-363-8929
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA80999207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine