Individual
DR. MITCHEL D BAUMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 5TH ST, SIOUX CITY, IA 51101-1394
(712) 279-2372
Mailing address
PO BOX 1463, SIOUX CITY, IA 51102-1463
(712) 279-2372
(712) 279-5631
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
26210
IA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
3879
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005647
WELLMARK BLX DUNEX
SD
05
—
0044727
—
IA
05
—
1044727
—
IA
01
—
31559
WELLMARK BLX
IA
Enumeration date
12/06/2005
Last updated
07/09/2007
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