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General NPI Number Information
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NPI Number | 1538783501
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Entity Type | Individual
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Provider Name | MITCH EDWARD PATRICK MD/PHD
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Gender | Male
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Dates
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Enumeration Date | 06/04/2020
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 200 HAWKINS DRIVE DEPARTMENT OF SURGERY
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City | IOWA CITY
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State | IA
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Zip | 52242
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Country | US
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Telephone | 319-356-1616
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Fax |
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Provider Business Mailing Address
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Address Line | 200 HAWKINS DR DEPT OF SURGERY
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City | IOWA CITY
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State | IA
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Zip | 52242-1009
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MD54913
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | R-11943
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License Number State | IA
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