Individual
HAMUTYINEI H MAMUTSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3512 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 483-9081
(260) 483-9196
Mailing address
PO BOX 392552, PITTSBURGH, PA 15251-9500
(260) 483-9081
(260) 483-9196
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.026184
OH
Other
Enumeration date
02/18/2020
Last updated
02/18/2020
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