| Doctor Name: | MARY LEROY KHOWASSAH |
| NPI Number: | 1740276096 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 17924 |
| Business Practice Address: | 4189 Westlawn S University Of Iowa Student Health Services Iowa City, IA - 522421100 |
| Business Phone Number: | 3193358370 |
| Business Fax Number: | 3193357247 |
| Mailing Address: | 4189 Westlawn S, University Of Iow Student Health Services IOWA CITY |
| State: | IA |
| Postal Code: | 522421100 |
| Phone Number: | 3193358370 |
| Fax Number: | 3193357247 |
| NPI Enumeration Date: | 09/22/2005 |
| NPI Last Update Date: | 09/28/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 17924 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |