Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 22111 | IA |
N | 111NI0900X | Internist | 22111 | IA |
Y | 207RA0201X | Internist - Allergy & Immunology | 22111 | IA |
NPI | 1316935943 |
---|---|
Provider Name | Zuhair K Ballas |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2005 |
Last Update Date | 28/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0172668 | (05) | IA |
17266 | WELLMARK BCBS (01) | IA |
A54859 | (02) |