Individual
MAMUA MARY ANDELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1125 N COLLEGE AVE # SLOT100, FAYETTEVILLE, AR 72703-1908
(479) 713-8700
(479) 714-8670
Mailing address
2306 W PIATT LN, OLATHE, KS 66061-5042
(913) 231-1338
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/08/2020
Last updated
04/08/2020
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