Individual
DR. MARK MUTUOTA GITAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
820 4TH ST N, FARGO, ND 58102-4539
(701) 234-6161
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
53892
MN
207RX0202X
Medical Oncology Physician
Primary
11318
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15203
—
ND
Enumeration date
06/19/2006
Last updated
06/27/2023
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