| Doctor Name: | MR. MITCHELL DAVIS |
| NPI Number: | 1386054039 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | Q307148741310 |
| Business Practice Address: | 111312 Village Rd Chaska, MN - 553181385 |
| Business Phone Number: | 6503219999 |
| Business Fax Number: | |
| Mailing Address: | 111312 Village Rd, CHASKA |
| State: | MN |
| Postal Code: | 553181385 |
| Phone Number: | 9522212237 |
| Fax Number: | |
| NPI Enumeration Date: | 05/04/2014 |
| NPI Last Update Date: | 05/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 242T00000X |
| License Number: | Q307148741310 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Perfusionist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A perfusionist operates extracorporeal circulation and autotransfusion equipment during any medical situation where it is necessary to support or temporarily replace the patient |