Provider Demographics
NPI:1124274105
Name:MITCHELL, CHRISTOPHER RYAN (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:RYAN
Last Name:MITCHELL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 FOULK ROAD
Mailing Address - Street 2:SUITE F
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810
Mailing Address - Country:US
Mailing Address - Phone:302-652-8990
Mailing Address - Fax:302-652-8646
Practice Address - Street 1:2000 FOULK ROAD
Practice Address - Street 2:SUITE F
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810
Practice Address - Country:US
Practice Address - Phone:302-652-8990
Practice Address - Fax:302-652-8646
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN52006208800000X
TN50005208800000X
DEC1-0011296208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNENROLLEDMedicaid
MNP00849744OtherMEDICARE RAILROAD
MN340001052Medicare PIN