Individual
DR. MITCHEL L. BERNSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2055 KIMBALL AVE STE 400, WATERLOO, IA 50702
(319) 272-0000
(319) 272-1329
Mailing address
2055 KIMBALL AVE STE 400, WATERLOO, IA 50702-5047
(319) 272-0000
(319) 272-1329
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25101
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2029272
—
IA
Enumeration date
05/28/2006
Last updated
06/27/2018
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