Provider Demographics
NPI:1821085549
Name:USACHEVA, MARINA Y (MD)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:Y
Last Name:USACHEVA
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:UNIVERSITY OF IOWA STUDENT HEALTH SERVICES
Mailing Address - Street 2:4189 WL
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1100
Mailing Address - Country:US
Mailing Address - Phone:319-335-8370
Mailing Address - Fax:319-335-7247
Practice Address - Street 1:UNIVERSITY OF IOWA STUDENT HEALTH SERVICES
Practice Address - Street 2:4189 WL
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1100
Practice Address - Country:US
Practice Address - Phone:319-335-8370
Practice Address - Fax:319-335-7247
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA35188207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA34739OtherWELLMARK BCBS
IA0298570Medicaid
IA34739OtherWELLMARK BCBS
H62497Medicare UPIN