Provider Demographics
NPI:1396942108
Name:JABBARI, SARVENAZ (MD)
Entity type:Individual
Prefix:
First Name:SARVENAZ
Middle Name:
Last Name:JABBARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NAZEE
Other - Middle Name:
Other - Last Name:JABBARI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:1825 LOGAN AVE
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50703-1916
Mailing Address - Country:US
Mailing Address - Phone:319-325-3885
Mailing Address - Fax:
Practice Address - Street 1:1825 LOGAN AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-1916
Practice Address - Country:US
Practice Address - Phone:319-325-3885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR8046208600000X
IA396852083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery