MEDICARE: ISHIMWE CIZA ERIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1023846060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISHIMWE CIZA ERIC

Provider Business Mailing Address
First Line	:	2107 S WASHINGTON AVE
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48910-2862
Country	:	US
Telephone Number	:	314-297-7228
Fax Number	:

Provider Business Practice Location Address
First Line	:	2107 S WASHINGTON AVE
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48910-2862
Country	:	US
Telephone Number	:	314-297-7228
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2024
Last Update Date	:	03/31/2026

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Directions to “ ISHIMWE CIZA ERIC ” Practice Location

Language	Start Address	Practice Location

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