Individual
DR. MWAWAZA MFIKIRI SANYIKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
393 E TOWN ST STE 228, COLUMBUS, OH 43215-4741
(614) 418-7771
(614) 241-5595
Mailing address
393 E TOWN ST STE 228, COLUMBUS, OH 43215-4741
(614) 418-7771
(614) 241-5595
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
207Q00000X
Family Medicine Physician
35081282
OH
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
022839750
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000249250
ANTHEM PROVIDER NUMBER
OH
05
—
2333942
—
OH
01
—
36D1003074
CLIA NUMBER
OH
Enumeration date
09/15/2006
Last updated
02/10/2020
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