Healthcare Provider Details

I. General information

NPI: 1013170448
Provider Name (Legal Business Name): PHUMEZA MSIKINYA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 36TH ST
BELLINGHAM WA
98225-6580
US

IV. Provider business mailing address

8209 MOREL DR
INDIANAPOLIS IN
46256-8107
US

V. Phone/Fax

Practice location:
  • Phone: 833-411-5469
  • Fax:
Mailing address:
  • Phone: 317-319-3905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number61540134
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: