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NPI Code Detail

MEDICARE: DAWN RENAE EBACH MD

MEDICARE: DAWN RENAE EBACH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080P0206XPediatric Gastroenterology Physician36059IA
2208000000XPediatrics Physician36059IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
139280OTHERIAWELLMARK BCBS

General Provider Information

NPI Number : 1457346231
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAWN RENAE EBACH MD
Provider Business Mailing Address
First Line : 200 HAWKINS DR
Second Line :
City : IOWA CITY
State : IA
Zip : 52242-1009
Country : US
Telephone Number : 319-356-8372
Fax Number : 319-356-8967
Provider Business Practice Location Address
First Line : 200 HAWKINS DR
Second Line :
City : IOWA CITY
State : IA
Zip : 52242-1009
Country : US
Telephone Number : 319-356-8372
Fax Number : 319-356-8967
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2005
Last Update Date : 09/05/2025

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Directions to “ DAWN RENAE EBACH MD” Practice Location

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