Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 38345 | IA |
Y | 2084N0402X | Child Neurologist | 38345 | IA |
N | 2084N0402X | Child Neurologist | 57-011386 | OH |
NPI | 1265609234 |
---|---|
Provider Name | Dr. Asit Kumar Tripathy |
First Address | Des Moines, IA 50309-1453 |
Second Address | Des Moines, IA 50309-1453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2008 |
Last Update Date | 23/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1720073083 | (05) | IA |