Provider Demographics
NPI:1114189115
Name:MITCHELL, MICHAEL DEAN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DEAN
Last Name:MITCHELL
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Gender:
Credentials:MD
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Mailing Address - Street 1:572 ROUTE 6
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541
Mailing Address - Country:US
Mailing Address - Phone:845-628-3530
Mailing Address - Fax:845-628-3548
Practice Address - Street 1:572 ROUTE 6
Practice Address - Street 2:SUITE 2
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541
Practice Address - Country:US
Practice Address - Phone:845-628-3530
Practice Address - Fax:845-628-3548
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2025-03-26
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Provider Licenses
StateLicense IDTaxonomies
NY1625682083A0300X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine