Individual
ANITA GATHONI WAMAKIMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-2000
Mailing address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-2000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MT220884
PA
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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