MEDICARE: MARY LEROY KHOWASSAH 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
1	208D00000X	General Practice Physician	17924	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	08972	OTHER	IA	WELLMARK BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740276096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY LEROY KHOWASSAH MD

Provider Business Mailing Address
First Line	:	4189 WESTLAWN S
Second Line	:	UNIVERSITY OF IOW STUDENT HEALTH SERVICES
City	:	IOWA CITY
State	:	IA
Zip	:	52242-1100
Country	:	US
Telephone Number	:	319-335-8370
Fax Number	:	319-335-7247

Provider Business Practice Location Address
First Line	:	4189 WESTLAWN S
Second Line	:	UNIVERSITY OF IOWA STUDENT HEALTH SERVICES
City	:	IOWA CITY
State	:	IA
Zip	:	52242-1100
Country	:	US
Telephone Number	:	319-335-8370
Fax Number	:	319-335-7247

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	09/28/2007

Similar Medicare Providers

1841293354 — KEITH BRYAN GUESS PA
Practice Location Address:

4189 WESTLAWN S
IOWA CITY, IA
52242-1100

Practice Phone: 319-335-8370
Practice Fax: 319-335-7247

1285635664 — STATE UNIVERSITY OF IOWA
Practice Location Address:

4189 WL UNIVERSITY OF IOWA
IOWA CITY, IA
52242-1100

Practice Phone: 319-335-8376
Practice Fax: 319-335-7247

1538153457 — DR. BARBARA L. PATRICK M.D.
Practice Location Address:

4189 WESTLAWN S
IOWA CITY, IA
52242-1100

Practice Phone: 319-335-8370
Practice Fax: 319-335-7247

1902892250 — JOY M HUDSON MD
Practice Location Address:

4189 WESTLAWN ST , UNIVERSITY OF IOWA STUDENT HEALTH SERVICES
IOWA CITY, IA
52242-1100

Practice Phone: 319-335-8370
Practice Fax: 319-335-7247

1730175571 — ERIC R EVANS MD
Practice Location Address:

4189 WESTLAWN S
IOWA CITY, IA
52242-1100

Practice Phone: 319-353-5959
Practice Fax: 319-335-7247

1568459188 — MARY F HACKER MD
Practice Location Address:

4189 WESTLAWN S
IOWA CITY, IA
52242-1100

Practice Phone: 319-335-8370
Practice Fax: 314-335-7247

Directions to “ MARY LEROY KHOWASSAH MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.