Provider Demographics
NPI:1437599701
Name:DHARWADKAR, MITALEE R (MD)
Entity type:Individual
Prefix:
First Name:MITALEE
Middle Name:R
Last Name:DHARWADKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:563-263-0339
Mailing Address - Fax:563-263-5081
Practice Address - Street 1:3465 MULBERRY AVE
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-2324
Practice Address - Country:US
Practice Address - Phone:563-263-0339
Practice Address - Fax:563-263-5081
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-42946207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine