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NPI Code Detail

MEDICARE: DR. MARK MUTUOTA GITAU M.D.

MEDICARE: DR. MARK MUTUOTA GITAU M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0003XHematology & Oncology Physician53892MN
2207RX0202XMedical Oncology Physician11318ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225073661
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK MUTUOTA GITAU M.D.
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 820 4TH ST N
Second Line :
City : FARGO
State : ND
Zip : 58102-4539
Country : US
Telephone Number : 701-234-6161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2006
Last Update Date : 06/27/2023

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