Individual
WILLIARD MAZHAWIDZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
13738 CHASE ST, CROWN POINT, IN 46307-9774
(270) 244-3829
Mailing address
13738 CHASE ST, CROWN POINT, IN 46307-9774
(270) 244-3829
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085006594
IL
363A00000X
Physician Assistant
Primary
10002653A
IN
Other
Enumeration date
09/25/2015
Last updated
11/07/2024
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