Individual
MAMOUN GWARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2705 E EMELITA AVE, MESA, AZ 85204-4630
(703) 844-1922
Mailing address
2705 E EMELITA AVE, MESA, AZ 85204-4630
(703) 844-1922
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171580
—
AZ
Enumeration date
06/19/2018
Last updated
01/27/2025
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