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Individual
DR. MBU MONGWA
Active
Individual
DR. MBU MONGWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036123786
IL
207R00000X
Internal Medicine Physician
056321
GA
207R00000X
Internal Medicine Physician
225666
NY
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
036123786
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123786
—
IL
01
—
P00753211
RAILROAD
—
Enumeration date
05/04/2007
Last updated
08/17/2016
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