Healthcare Provider Details

I. General information

NPI: 1962719476
Provider Name (Legal Business Name): MARGARET A. SMOLLEN, M.D, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2010
Last Update Date: 09/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 E BLOOMINGTON ST
IOWA CITY IA
52245-2103
US

IV. Provider business mailing address

319 E BLOOMINGTON ST
IOWA CITY IA
52245-2103
US

V. Phone/Fax

Practice location:
  • Phone: 319-887-2229
  • Fax:
Mailing address:
  • Phone: 319-887-2229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number27112
License Number StateIA

VIII. Authorized Official

Name: DR. MARGARET ALICE SMOLLEN
Title or Position: PRESIDENT
Credential: MD
Phone: 319-887-2229