Individual
ANDREW MWANGI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1657 COMMERCE DR STE 15A, SOUTH BEND, IN 46628-1547
(574) 339-7768
(574) 383-6767
Mailing address
1657 COMMERCE DR STE 15A, SOUTH BEND, IN 46628-1547
(574) 339-7768
(574) 383-6767
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
344600000X
Taxi
—
—
347C00000X
Private Vehicle
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300036738
—
IN
Enumeration date
05/27/2020
Last updated
08/11/2021
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