Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 34448 | IA |
N | 2080P0207X | Pediatric Hematology-Oncologist | PT11814 | ND |
NPI | 1114913985 |
---|---|
Provider Name | Torrey L Mitchell |
First Address | West Des Moines, IA 50266-7563 |
Second Address | Des Moines, IA 50309-1416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 17/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0252601 | (05) | IA |
15670 | (05) | ND |
D15165 | (02) |