Individual
MIKA IWANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1001 MAIN ST FL 5, BUFFALO, NY 14203-1009
(716) 323-0220
Mailing address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5461
(602) 344-5805
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
57098
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/24/2012
Last updated
10/15/2021
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