Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Thaddeus Dwayne Mitcham, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1497120760

Mr. Thaddeus Dwayne Mitcham, PHYSICIANASSISTANT is a Physician Assistant in Andersen AFB, Guam. Registered with an NPI since 2015.

In the registry since
2015

Practice location Address may be wrong

The ZIP code does not match the city and state on this record. Call before visiting.

36TH Medical Group Unit 14010 Bldg 26012
Andersen AFB, GU 96543-4003
Phone: (671) 366-4549

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1497120760
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedDecember 11, 2015
Last updated in NPPESAugust 14, 2024
Certification dateAugust 8, 2024

Other providers in Andersen AFB