Mr Thaddeus Dwayne Mitcham, PHYSICIAN ASSISTANT | |
36th Medical Group, Unit 14010 Bldg 26012, Andersen Afb, GU 96543-4003 | |
(671) 366-4549 | |
Not Available |
Full Name | Mr Thaddeus Dwayne Mitcham |
---|---|
Gender | Male |
Speciality | Physician Assistant |
Location | 36th Medical Group, Andersen Afb, Guam |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497120760 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363A00000X | Physician Assistant | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
Mr Thaddeus Dwayne Mitcham, PHYSICIAN ASSISTANT 36th Medical Group, Unit 14010 Bldg 26012, Andersen Afb, GU 96543-4003 Ph: (671) 366-4549 | Mr Thaddeus Dwayne Mitcham, PHYSICIAN ASSISTANT 36th Medical Group, Unit 14010 Bldg 26012, Andersen Afb, GU 96543-4003 Ph: (671) 366-4549 |
Amanda Jo Solven, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 36th Medical Group, Unit 14010 Bldg. 26012, Andersen Afb, GU 96543 Phone: 671-366-9355 |