Provider Demographics
NPI:1225712615
Name:BOUS, RAFIK (MD)
Entity Type:Individual
Prefix:
First Name:RAFIK
Middle Name:
Last Name:BOUS
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:DEPARTMENT OF FAMILY MEDICINE 200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY, IOWA
Mailing Address - State:IA
Mailing Address - Zip Code:52242
Mailing Address - Country:US
Mailing Address - Phone:319-384-7222
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF FAMILY MEDICINE 200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY, IOWA
Practice Address - State:IA
Practice Address - Zip Code:52242
Practice Address - Country:US
Practice Address - Phone:319-384-7222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-12752207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine