IndividualActive
Thaddeus Mitcham, PHYSICIAN ASSISTANT
NPI 1497120760 · Physician Assistant · Andersen Afb, GU
Provider details
- NPI number
- 1497120760
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PHYSICIAN ASSISTANT
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
36th Medical Group
Unit 14010 Bldg 26012
Andersen Afb, GU 96543-4003
Phone: (671) 366-4549
Approximate (ZIP-level) locationGet directions
Mailing address
36th Medical Group
Andersen Afb, GU 96543-4003
Registry dates
- Enumerated
- 2015-12-11
- Last updated
- 2024-08-14
- Certified
- 2024-08-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.