Healthcare Provider Details

I. General information

NPI: 1780638171
Provider Name (Legal Business Name): TAREK MICHEL DAOUD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 02/07/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1753 W RIDGEWAY AVE STE 105
WATERLOO IA
50701-4588
US

IV. Provider business mailing address

PO BOX 2758
WATERLOO IA
50704-2758
US

V. Phone/Fax

Practice location:
  • Phone: 319-833-5940
  • Fax: 319-833-5941
Mailing address:
  • Phone: 319-833-5940
  • Fax: 319-833-5941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number34551
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: