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General NPI Number Information
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NPI Number | 1730920570
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Entity Type | Individual
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Provider Name | AMMARA SHAMSHAD M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 2055 KIMBAL AVE, STE 101 MERCY ONE NORTHEAST IOWA
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City | WATERLOO
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State | IA
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Zip | 50702
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Country | US
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Telephone | 319-272-2529
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Fax | 319-272-2527
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Provider Business Mailing Address
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Address Line | 2055 KIMBAL AVE, STE 101 MERCY ONE NORTHEAST IOWA
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City | WATERLOO
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State | IA
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Zip | 50702
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Country | US
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Telephone | 319-272-2112
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R-13122
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License Number State | IA
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