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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801884754 NPPES
Iowa Other 04197 WELLMARK BCBS
Iowa MEDICAID 0432013 WELLMARK BCBS

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