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Individual

DR. MITCHELL LEE BLOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
405 MONROE ST, PELLA, IA 50219-1189
(641) 621-2200
(641) 621-2335
Mailing address
405 MONROE ST, PELLA, IA 50219-1189
(641) 621-2200
(641) 621-2335

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3272
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110128513
RAILROAD MEDICARE
IA
05
3210203
IA
Enumeration date
01/20/2006
Last updated
08/30/2022
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