Provider Demographics
NPI:1205952959
Name:CHIRWA, MARGERY ULEMA (MD)
Entity type:Individual
Prefix:
First Name:MARGERY
Middle Name:ULEMA
Last Name:CHIRWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:264 N HIGHLAND SPRINGS AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-3082
Mailing Address - Country:US
Mailing Address - Phone:951-845-8856
Mailing Address - Fax:951-845-7256
Practice Address - Street 1:12980 FREDERICK ST
Practice Address - Street 2:SUITE C
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-5263
Practice Address - Country:US
Practice Address - Phone:951-242-5760
Practice Address - Fax:951-242-5830
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG64481207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG64481OtherTRICARE
CA00G644810Medicaid
CAG64481OtherTRICARE
CA00G644810Medicaid