Provider Demographics
NPI:1134965882
Name:TEJEDOR BRAVO, MARTA (PHD, MBBS)
Entity type:Individual
Prefix:
First Name:MARTA
Middle Name:
Last Name:TEJEDOR BRAVO
Suffix:
Gender:F
Credentials:PHD, MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-467-8100
Mailing Address - Fax:319-384-8559
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-467-8100
Practice Address - Fax:319-384-8559
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IASP-0284207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology