Individual provider · Type 1 NPI

Mamua Mary Andela, MD

Student in an Organized Health Care Education/Training Program · Fayetteville, AR

NPI number 1306465588 Active

Practice location

1125 N College Ave # SLOT100
Fayetteville, AR 72703-1908

Call (479) 713-8700 Map

Fax (479) 714-8670

Mailing address

2306 W Piatt Ln
Olathe, KS 66061-5042

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1306465588

Mamua Mary Andela, MD's National Provider Identifier is 1306465588, issued on Apr 8, 2020. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fayetteville, AR. The record was last updated on Apr 8, 2020.