# DR. JWAN M MUSTAFA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1154020923
- **Gender:** F
- **Credential:** PHARMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | P10029 | ID | Yes |

## Other

- **Enumeration date:** 03/01/2023
- **Last updated:** 06/08/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | P10029 | PHARMACIST | ID |