| Doctor Name: | TIMOTHY A MITCHELL |
| NPI Number: | 1841208519 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 82182 |
| Business Practice Address: | 27 Brentwood Rd Cape Elizabeth, ME - 041072224 |
| Business Phone Number: | 2077671644 |
| Business Fax Number: | |
| Mailing Address: | 27 Brentwood Rd, CAPE ELIZABETH |
| State: | ME |
| Postal Code: | 041072224 |
| Phone Number: | 2077671644 |
| Fax Number: | |
| NPI Enumeration Date: | 08/04/2006 |
| NPI Last Update Date: | 06/12/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | 82182 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |