Provider Demographics
NPI:1124140009
Name:TAILOUNIE, MUAYYAD (MD)
Entity type:Individual
Prefix:
First Name:MUAYYAD
Middle Name:
Last Name:TAILOUNIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-353-7534
Mailing Address - Fax:319-356-2940
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-353-7534
Practice Address - Fax:319-356-2940
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA40036207L00000X, 207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAMD-40036OtherIOWA MEDICAL LICENSE
OH3057141Medicaid
OH000000674768OtherANTHEM
OH06959OtherPARAMOUNT
OH69879OtherHEALTH PLAN OF MICHIGAN
OH4296491Medicare PIN