Provider Demographics
NPI:1144112574
Name:MITCHELL FAMILY DERMATOLOGY LLC
Entity type:Organization
Organization Name:MITCHELL FAMILY DERMATOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-323-9261
Mailing Address - Street 1:8191 PETERS RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-8105
Mailing Address - Country:US
Mailing Address - Phone:919-323-9261
Mailing Address - Fax:
Practice Address - Street 1:11236 ROBINWOOD DR STE 102
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6800
Practice Address - Country:US
Practice Address - Phone:301-936-7736
Practice Address - Fax:301-750-9896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty