Individual
BENJAMIN ISAAC MWANIKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2509 PLEASANT RUN DR, HARRISONBURG, VA 22801-8720
(540) 689-5500
(540) 757-7574
Mailing address
11511 SHADOW CREEK PKWY, PEARLAND, TX 77584-7298
(713) 442-0000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
T9755
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
0102203559
VA
207QS0010X
Sports Medicine (Family Medicine) Physician
T9755
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457595258
—
VA
Enumeration date
04/23/2009
Last updated
09/26/2022
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