Doctor Name: | TAKASHI KAWAMITSU |
NPI Number: | 1033295308 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 21889 |
Business Practice Address: | 1 Edmundson Pl Council Bluffs, IA - 515034658 |
Business Phone Number: | 7123964340 |
Business Fax Number: | 7123964180 |
Mailing Address: | Po Box 3755, OMAHA |
State: | NE |
Postal Code: | 681030755 |
Phone Number: | 4023542100 |
Fax Number: | 4023542155 |
NPI Enumeration Date: | 10/31/2006 |
NPI Last Update Date: | 07/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | 21889 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NE |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |