Provider Demographics
NPI:1396726436
Name:MITCHELL, DONNA FLEITZ (MD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:FLEITZ
Last Name:MITCHELL
Suffix:
Gender:F
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:PO BOX 668
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80001-0668
Mailing Address - Country:US
Mailing Address - Phone:303-422-9438
Mailing Address - Fax:303-422-9474
Practice Address - Street 1:1819 DENVER WEST DR
Practice Address - Street 2:26-200
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-3118
Practice Address - Country:US
Practice Address - Phone:303-422-9438
Practice Address - Fax:303-422-9474
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39108207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO98480871Medicaid
CO98480871Medicaid
COC63482Medicare UPIN