Basic Information
| Provider Information | |||||||||
| NPI: | 1831338755 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PITCHER | ||||||||
| FirstName: | GRAEME | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | MB BCH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 HAWKINS DR | ||||||||
| Address2: | |||||||||
| City: | IOWA CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 522421009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193561763 | ||||||||
| FaxNumber: | 3193568378 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 HAWKINS DR | ||||||||
| Address2: | |||||||||
| City: | IOWA CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 52242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193561763 | ||||||||
| FaxNumber: | 3193568378 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2009 | ||||||||
| LastUpdateDate: | 05/25/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | SP-193 | IA | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0120X | SP-193 | IA | Y | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery |
No ID Information.