Provider Demographics
NPI:1447813738
Name:MZOMBWE, MAJALIWA (MD)
Entity type:Individual
Prefix:DR
First Name:MAJALIWA
Middle Name:
Last Name:MZOMBWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 DIVISION AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-5429
Mailing Address - Country:US
Mailing Address - Phone:541-743-9003
Mailing Address - Fax:
Practice Address - Street 1:217 DIVISION AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-5429
Practice Address - Country:US
Practice Address - Phone:541-743-9003
Practice Address - Fax:541-284-0520
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-22
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORFE217054208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine