Individual provider · Type 1 NPI

Mitchell Paul Fornwald, DO, MBS

Student in an Organized Health Care Education/Training Program · Wilkes Barre, PA

NPI number 1144158080 Active

Practice location

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027

Call (570) 808-7300 Map

Other practice locations

  • 1800 Mulberry St, Scranton, PA 18510-2369 · (570) 703-8000

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1144158080

Mitchell Paul Fornwald, DO, MBS's National Provider Identifier is 1144158080, issued on May 11, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Wilkes Barre, PA. The record was last updated on May 11, 2026.