Blom, Mitchell Lee

Blom, Mitchell Lee is an individual health care provider with primary practice located at 405 Monroe St , Pella IA 50219-1189. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Blom, Mitchell Lee can be contacted via phone (641) 621-2200.

Contact Information

Primary practice address
405 Monroe St Pella IA 50219-1189
Phone: (641) 621-2200
Fax: (641) 621-2335
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 3272 Iowa

Profile Details

NPI number 1558341917
LBN Legal business name Blom, Mitchell Lee
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Aug 30th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558341917 NPPES
Iowa MEDICAID 3210203
Iowa Other 110128513

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