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Individual

EDWIN WAHOME MWANGI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
3105 MCCLELLAND BLVD, JOPLIN, MO 64804-1640
(417) 781-2807
(417) 781-3309
Mailing address
3105 MCCLELLAND BLVD, JOPLIN, MO 64804-1640
(417) 781-2807
(417) 781-3309

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
2012004801
MO
363A00000X
Physician Assistant
Primary
2012004801
MO

Other

Enumeration date
02/15/2012
Last updated
05/10/2018
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