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Individual

MARIA L MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2301 E 14TH ST, DES MOINES, IA 50316-1901
(515) 262-0404
(515) 262-0489
Mailing address
2301 E 14TH ST, DES MOINES, IA 50316-1901
(515) 262-0404
(515) 262-0489

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26667
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080188604
RAILROAD MEDICARE NUMBER
IA
05
1285693796
IA
05
6032268
IA
Enumeration date
03/22/2006
Last updated
08/15/2012
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