Individual
DR. VICTOR MWANSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3331 W DEYOUNG ST, SUITE 100, MARION, IL 62959-5896
(618) 998-7600
(618) 997-6680
Mailing address
3331 W DEYOUNG ST, SUITE 100, MARION, IL 62959-5896
(618) 998-7600
(618) 997-6680
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036118765
IL
207RI0011X
Interventional Cardiology Physician
Primary
36118765
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036118765
—
IL
Enumeration date
06/29/2007
Last updated
12/11/2023
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