Individual
SHADI SUHAIL MUSTAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2055 KIMBALL AVE STE 101, WATERLOO, IA 50702-5047
(319) 272-2112
(319) 272-2107
Mailing address
2055 KIMBALL AVE STE 101, WATERLOO, IA 50702-5047
(319) 272-2112
(319) 272-2107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R-11097
IA
Other
Enumeration date
05/16/2018
Last updated
05/16/2018
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