Healthcare Provider Details

I. General information

NPI: 1033045984
Provider Name (Legal Business Name): JULIANO REIS FREITAS COSTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JULIANO REIS FREITAS COSTA MD

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-356-2633
  • Fax: 319-356-2940
Mailing address:
  • Phone: 319-356-2633
  • Fax: 319-356-2940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberSP-0366
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: