Provider Demographics
NPI:1548405319
Name:EBERT, MARY (DVM)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:EBERT
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 HIGHWAY 1 W
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4251
Mailing Address - Country:US
Mailing Address - Phone:319-354-6696
Mailing Address - Fax:
Practice Address - Street 1:705 HIGHWAY 1 W
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-4251
Practice Address - Country:US
Practice Address - Phone:319-354-6696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA5567174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian