Provider Demographics
NPI:1699722488
Name:MITCHELL, RENAE ROCHELLE (DO)
Entity type:Individual
Prefix:
First Name:RENAE
Middle Name:ROCHELLE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RENAE
Other - Middle Name:MITCHELL
Other - Last Name:FREID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:62 BROWN ST. SUITE 405
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6790
Mailing Address - Country:US
Mailing Address - Phone:978-521-8377
Mailing Address - Fax:978-521-3689
Practice Address - Street 1:62 BROWN ST. SUITE 405
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6790
Practice Address - Country:US
Practice Address - Phone:978-521-8377
Practice Address - Fax:978-521-3689
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158397207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine