Provider Demographics
NPI: | 1891055612 |
---|---|
Name: | JAWA, ZEESHAN ALI (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | ZEESHAN |
Middle Name: | ALI |
Last Name: | JAWA |
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: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1221 PLEASANT ST STE 100 |
Practice Address - Street 2: | |
Practice Address - City: | DES MOINES |
Practice Address - State: | IA |
Practice Address - Zip Code: | 50309-1424 |
Practice Address - Country: | US |
Practice Address - Phone: | 515-282-2921 |
Practice Address - Fax: | 515-282-1035 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2012-05-26 |
Last Update Date: | 2025-02-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
IA | 45206 | 207R00000X, 207RH0000X, 207RX0202X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RX0202X | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
No | 207RH0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
WI | 1891055612 | Medicaid |