Provider Demographics
NPI:1952144883
Name:MITCHELL, HERBERT MARK
Entity type:Individual
Prefix:
First Name:HERBERT
Middle Name:MARK
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 TILLOTSON RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-5105
Mailing Address - Country:US
Mailing Address - Phone:864-296-6911
Mailing Address - Fax:
Practice Address - Street 1:780 TILLOTSON RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-5105
Practice Address - Country:US
Practice Address - Phone:864-296-6911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other