Provider Demographics
NPI:1760702229
Name:SAVAGE, JOHANNA MARIE (MD)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:MARIE
Last Name:SAVAGE
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 1:200 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:319-384-9609
Mailing Address - Fax:319-356-2987
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:319-384-9609
Practice Address - Fax:319-356-2987
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-41587207ZP0102X
UT10378766-1205207ZP0102X
OH35136595207ZP0102X
TN66400207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0358377Medicaid
TNQ079761Medicaid