Provider Demographics
NPI:1003128141
Name:DODD, KHUSHMAN (MD)
Entity Type:Individual
Prefix:
First Name:KHUSHMAN
Middle Name:
Last Name:DODD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 PRAIRIE PKWY STE 301
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-8155
Mailing Address - Country:US
Mailing Address - Phone:319-277-1990
Mailing Address - Fax:319-222-2999
Practice Address - Street 1:5100 PRAIRIE PKWY STE 301
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-8155
Practice Address - Country:US
Practice Address - Phone:319-277-1990
Practice Address - Fax:319-222-2999
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA40738207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine