Individual
DANIEL MWANZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1425 PORTLAND AVE, ROCHESTER, NY 14621-3011
(585) 922-4518
(585) 336-5113
Mailing address
1425 PORTLAND AVE, ROCHESTER, NY 14621-3011
(585) 922-4518
(585) 336-5113
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
02003845A
IN
208600000X
Surgery Physician
S9359
TX
2086S0127X
Trauma Surgery Physician
S9359
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200686170A
—
OK
05
—
218263003
—
AR
Enumeration date
05/31/2011
Last updated
09/13/2023
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