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Individual

DR. THOMAS EDWARD DITTMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 MORGAN ST, KEOKUK, IA 52632-3456
(319) 526-8750
(319) 524-5317
Mailing address
1600 MORGAN ST, KEOKUK, IA 52632-3456
(319) 526-8750
(319) 524-5317

Taxonomy

Speciality
Code
Description
License number
State
207ZM0300X
Medical Microbiology Physician
Primary
35921
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0457275
IA
01
38633
BLUE CROSS
IA
Enumeration date
07/26/2006
Last updated
07/08/2007
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