Individual
MARY LEROY KHOWASSAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4189 WESTLAWN S, UNIVERSITY OF IOWA STUDENT HEALTH SERVICES, IOWA CITY, IA 52242-1100
(319) 335-8370
(319) 335-7247
Mailing address
4189 WESTLAWN S, UNIVERSITY OF IOW STUDENT HEALTH SERVICES, IOWA CITY, IA 52242-1100
(319) 335-8370
(319) 335-7247
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
17924
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0089722
—
IA
01
—
08972
WELLMARK BCBS
IA
Enumeration date
09/22/2005
Last updated
09/28/2007
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