Fasano, Mary Beth
Fasano, Mary Beth is an individual health care provider with primary practice located at 200 Hawkins Dr , Iowa City IA 52242-1009. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Allergy & Immunology is her primary health care specialty. Fasano, Mary Beth can be contacted via phone (319) 356-3692.Contact Information
Primary practice address
200 Hawkins Dr
Iowa City IA 52242-1009
Phone: (319) 356-3692
Fax: (319) 356-8280
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 35451 | Iowa |
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207RA0201X | 35451 | Iowa |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 35451 | Iowa |
Profile Details
| NPI number | 1801884754 |
|---|---|
| LBN Legal business name | Fasano, Mary Beth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2005 |
| Last updated | Nov 29th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801884754 | NPPES |
| Iowa | Other | 04197 | WELLMARK BCBS |
| Iowa | MEDICAID | 0432013 | WELLMARK BCBS |
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