Provider Demographics
NPI:1801693825
Name:MUGEMA, ANDREW JR
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:MUGEMA
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5249 N PARK PL NE # 1049
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-6210
Mailing Address - Country:US
Mailing Address - Phone:319-538-2866
Mailing Address - Fax:
Practice Address - Street 1:5249 N PARK PL NE # 1049
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-6210
Practice Address - Country:US
Practice Address - Phone:319-538-2866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider