Doctor Name: | MR. MIKE C CORSBERG |
NPI Number: | 1982787727 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | 00900 |
Business Practice Address: | 610 Main Manson, IA - 50563 |
Business Phone Number: | 5159557171 |
Business Fax Number: | 5155737898 |
Mailing Address: | 610 Main, MANSON |
State: | IA |
Postal Code: | 50563 |
Phone Number: | 5159557171 |
Fax Number: | 5155737898 |
NPI Enumeration Date: | 10/23/2006 |
NPI Last Update Date: | 01/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 00900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |