Provider Demographics
NPI:1255316303
Name:KING, DANA MARIE (MD)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:MARIE
Last Name:KING
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:MARIE
Other - Last Name:COLLAGUAZO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
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:319-356-6360
Mailing Address - Fax:319-384-9184
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:319-356-6360
Practice Address - Fax:319-384-9184
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA35089207P00000X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA34721OtherWELLMARK BCBS
IA34721OtherWELLMARK BCBS
IAI9579Medicare PIN
IAP00026202Medicare PIN
H66395Medicare UPIN