Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SIDE MITCHELL MACK JR., PA
ActiveSIDE MITCHELL MACK JR., PA is a Physician Assistant healthcare provider located in GREENSBORO, North Carolina. NPI 1740232966 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · GREENSBORO, NC
Registration Details
- NPI Number
- 1740232966
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 16, 2006 (20.236511279071 yrs)
- Last Updated
- Feb 1, 2022
- Licenses
-
1000323 (NC)0010-00323 (NC)
Practice Information
- Address
-
1309 LEES CHAPEL RDGREENSBORO, NC, 274552601Browse NC providers · Browse ZIP 27455
- Phone
- 3362865505
- Fax
- 3362882900
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in GREENSBORO, NC
| Name | Credential | NPI |
|---|---|---|
| CAROL DONAHUE KNOWLES | PA-C | 1912900838 |
| MR. EASTON MARTIN RICE III | DHSC, MPAS, PA-C | 1518961937 |
| MYRON RODDENBERRY | PA | 1346245040 |
| STEPHEN P HINMAN | PA | 1255330098 |
| KELLY STEVENS | PA | 1104811959 |
| DAVID SEVIER SPAINHOUR | P.A. | 1942295571 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.