Healthcare Provider Details

I. General information

NPI: 1023702909
Provider Name (Legal Business Name): RORISANG PHEKU MOROBE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RORISANG ROSINA PHEKU MD

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 BLAIRS FERRY RD
HIAWATHA IA
52233-2033
US

IV. Provider business mailing address

1790 BLAIRS FERRY RD
HIAWATHA IA
52233-2033
US

V. Phone/Fax

Practice location:
  • Phone: 319-294-4967
  • Fax: 319-294-1194
Mailing address:
  • Phone: 319-294-4967
  • Fax: 319-294-1194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-55483
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: