Provider Demographics
NPI:1942655063
Name:WAHBA, AMR TAREK
Entity type:Individual
Prefix:
First Name:AMR
Middle Name:TAREK
Last Name:WAHBA
Suffix:
Gender:M
Credentials:
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:319-384-8308
Mailing Address - Fax:319-353-7850
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:319-384-8308
Practice Address - Fax:319-353-7850
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN60014207R00000X, 208U00000X
IAMD-53283207R00000X, 207RE0101X
IAR-12356207RE0101X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program