MR. Thaddeus Dwayne Mitcham, PHYSICIAN ASSISTANT
NPI #1497120760 in Andersen Afb, Guam
Provider Information
- NPI Number
- 1497120760
- Entity Type
- Individual
- Name
- MR. Thaddeus Dwayne Mitcham, PHYSICIAN ASSISTANT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PHYSICIAN ASSISTANT
- Enumeration Date
- Dec 11, 2015
- Last Updated
- Aug 14, 2024
Practice Location
- Address
- 36TH MEDICAL GROUP
- Address 2
- UNIT 14010 BLDG 26012
- City
- Andersen Afb
- State
- Guam
- ZIP Code
- 96543-4003
- Phone
- (671) 366-4549
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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