Individual
TAKASHI KAWAMITSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 EDMUNDSON PL, COUNCIL BLUFFS, IA 51503-4658
(712) 396-4340
(712) 396-4180
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34312
IA
207QA0505X
Adult Medicine Physician
21889
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033295308
—
IA
05
—
47068731712
—
NE
Enumeration date
10/31/2006
Last updated
07/14/2014
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