Provider Demographics
NPI:1801056874
Name:DRIVER, GYOBANNA C (MD)
Entity type:Individual
Prefix:
First Name:GYOBANNA
Middle Name:C
Last Name:DRIVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2055 KIMBALL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5014
Mailing Address - Country:US
Mailing Address - Phone:319-272-2112
Mailing Address - Fax:319-272-2107
Practice Address - Street 1:2055 KIMBALL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5014
Practice Address - Country:US
Practice Address - Phone:319-272-2112
Practice Address - Fax:319-272-2107
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAR-8306207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine