| 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 |