Basic Information
Provider Information
NPI: 1982084463
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABUKHALIL
FirstName: SAFA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.B.B.S
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 HAWKINS DR
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3194672000
FaxNumber: 3194672815
Practice Location
Address1: 1765 LININGER LN
Address2:  
City: NORTH LIBERTY
State: IA
PostalCode: 523172335
CountryCode: US
TelephoneNumber: 3194677888
FaxNumber: 3194677889
Other Information
ProviderEnumerationDate: 06/01/2015
LastUpdateDate: 07/08/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XMD-44570IAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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