Provider Demographics
NPI:1427400852
Name:MWANSA, HUNTER (MD)
Entity Type:Individual
Prefix:DR
First Name:HUNTER
Middle Name:
Last Name:MWANSA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HUNTER
Other - Middle Name:
Other - Last Name:MWANSA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1800 N. CAPITOL AVENUE, E371
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202
Mailing Address - Country:US
Mailing Address - Phone:317-274-0700
Mailing Address - Fax:
Practice Address - Street 1:1800 N. CAPITOL AVENUE, E371
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-274-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-09
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01090208A207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine