Provider Demographics
NPI:1609166180
Name:SYRING, MARA B (DO)
Entity Type:Individual
Prefix:
First Name:MARA
Middle Name:B
Last Name:SYRING
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MARA
Other - Middle Name:CAROLINE
Other - Last Name:BACON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1215 DUFF AVENUE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-3014
Mailing Address - Country:US
Mailing Address - Phone:515-239-6855
Mailing Address - Fax:515-956-2782
Practice Address - Street 1:1111 DUFF AVENUE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3014
Practice Address - Country:US
Practice Address - Phone:515-239-6855
Practice Address - Fax:515-956-2782
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ006459208M00000X
IA05104208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist