NPI 1497120760

Thaddeus Dwayne Mitcham, PHYSICIANASSISTANT

Practitioner Physician Assistant Andersen Afb, GU

Practice location

Address: 36th Medical Group Unit 14010 Bldg 26012, Andersen Afb, GU 96543-4003
Phone: (671) 366-4549

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

Other Physician Assistant providers in Guam →

Registry record

NPI: 1497120760
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Dec 2015
Record last updated: 14 Aug 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.