Organization
DIAGNOSTIC & CRITICAL CARE MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MITCH HARRIS (ADMINISTRATOR)
(515) 865-4567
Entity
Organization
Contact information
Practice address
1510 PLEASANT VIEW DR, DES MOINES, IA 50315-2126
(515) 771-2527
(855) 642-1942
Mailing address
411 LAUREL ST, STE 3275, DES MOINES, IA 50314-3027
(515) 247-4113
(515) 643-8779
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0000
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0071233
—
IA
Enumeration date
06/20/2005
Last updated
12/13/2022
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