# DR. MBU MONGWA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1295947083
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 036123786 | IL | — |
| 207R00000X | Internal Medicine Physician | 056321 | GA | — |
| 207R00000X | Internal Medicine Physician | 225666 | NY | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | 036123786 | IL | Yes |

## Other

- **Enumeration date:** 05/04/2007
- **Last updated:** 08/17/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036123786 | — | IL |
| 01 | — | P00753211 | RAILROAD | — |