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MR. THADDEUS DWAYNE MITCHAM PHYSICIAN ASSISTANT
NPI 1497120760
Physician Assistant in Andersen Afb, GU

Active since December 11, 2015
36TH MEDICAL GROUP, UNIT 14010 BLDG 26012, ANDERSEN AFB, GU 96543(671) 366-4549 Get Directions Write a Review

NPPES record last updated: August 14, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 14, 2024, Aug 18, 2023, Apr 19, 2018 and 1 more (4 updates tracked since 2015).

About Mr. Thaddeus Dwayne Mitcham Physician Assistant NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. THADDEUS DWAYNE MITCHAM PHYSICIAN ASSISTANT (NPI 1497120760) is an individual physician assistant in Andersen Afb, Guam and active in the NPI registry since December 2015.

NPPES Registry Identity

NPI1497120760
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. THADDEUS DWAYNE MITCHAMCredential: PHYSICIAN ASSISTANT
Location Address36TH MEDICAL GROUP, UNIT 14010 BLDG 26012Andersen Afb, GU 96543-4003
Mailing Address36th Medical Group, Unit 14010 Bldg 26012Andersen Afb, GU 96543-4003 · (671) 366-4549
Phone(671) 366-4549
Sole ProprietorNo
Enumeration DateDecember 11, 2015
Last NPPES UpdateAugust 14, 20244 updates tracked since enumeration
NPPES CertifiedAugust 8, 2024
✔ NPI 1497120760 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. CYNTHIA E BYAS MS MA LMFT LAC
Marriage & Family Therapist
36TH MEDICAL GROUP, UNIT 14010 BLDG 26012
APO, AP 96543
(671) 366-3326
AMANDA JO SOLVEN PA-C
Physician Assistant
36TH MEDICAL GROUP, UNIT 14010 BLDG. 26012
ANDERSEN AFB, GU 96543
(671) 366-9355
ALEXANDRA ELIZABETH CHURCHILL MD
Emergency Medicine
36TH MEDICAL GROUP, UNIT 14010 BLDG. 26012
APO, AP 96543
(671) 366-9355
BREANNA MARIE BROCK
Physical Therapist
36TH MEDICAL GROUP, UNIT 14010 BLDG. 26012
APO, AP 96543
(671) 366-2419
SHIRLEY ZISER LCSW
Social Worker (Clinical)
36TH MEDICAL GROUP, UNIT 14010 BLDG. 26012
APO AP, GU 96543
(315) 366-3326
MRS. REBECCA JOYCE SCOTT PHARMD
Pharmacist
36TH MEDICAL GROUP, UNIT 14010 BLDG 26001
APO, AP 96543
(671) 366-5271
MADELINE BARRON OD
Optometrist
36TH MEDICAL GROUP, UNIT 14010 BLDG. 26012
ANDERSEN AFB APO, AP 96543
(920) 621-6368
DR. JACOB BESSLER M.D.
Internal Medicine
36TH MEDICAL GROUP, UNIT 14010 BLDG 26012
ANDERSEN AFB APO, AP 96543
(315) 366-3326

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thaddeus Mitcham's NPI number?

The NPI number for Thaddeus Mitcham is 1497120760. It was assigned to this individual provider in the NPPES registry on December 11, 2015.

Where is Thaddeus Mitcham located?

Thaddeus Mitcham practices at 36th Medical Group Unit 14010 Bldg 26012, Andersen Afb, GU 96543. The listed phone number is (671) 366-4549.

What is Thaddeus Mitcham's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Thaddeus Mitcham was last updated on August 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.