Imm, Mitchell Dongjun
Imm, Mitchell Dongjun is an individual health care provider with primary practice located at 10647 Bramblecrest Dr , Austin TX 78726-1906. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine is his primary health care specialty. Imm, Mitchell Dongjun can be contacted via phone (512) 906-1974.Contact Information
Primary practice address
10647 Bramblecrest Dr
Austin TX 78726-1906
Phone: (512) 906-1974
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 200200707 | North Carolina |
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 200200707 | North Carolina |
Profile Details
| NPI number | 1790731230 |
|---|---|
| LBN Legal business name | Imm, Mitchell Dongjun |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 26th, 2006 |
| Last updated | Sep 2nd, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790731230 | NPPES |
| North Carolina | MEDICAID | 89131UT | |
| North Carolina | Other | 131UT | |
| North Carolina | Other | 7355461 | |
| North Carolina | Other | D8866 |
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