Healthcare Provider Details

I. General information

NPI: 1699574277
Provider Name (Legal Business Name): FERNANDO MACIEL BARBOSA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
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: 319-356-2353
  • Fax: 319-348-9874
Mailing address:
  • Phone: 319-356-2353
  • Fax: 319-348-9874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberSP-0306
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberSP-0306
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: