Healthcare Provider Details

I. General information

NPI: 1245902121
Provider Name (Legal Business Name): AYMAN AHMAD GHATTAS MD,MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 09/02/2026
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MEDICAL PARKWAY
DENISON IA
51442
US

IV. Provider business mailing address

100 MEDICAL PARKWAY
DENISON IA
51442
US

V. Phone/Fax

Practice location:
  • Phone: 712-265-2500
  • Fax:
Mailing address:
  • Phone: 712-265-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD-56672
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-51697
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: