Individual
MR. MANSURU MUSTAPHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
9119 MIL PARK AVE, WINDER CLINIC -RAIDER CLINIC, JBLM, WA 98433-1100
(253) 477-0800
Mailing address
MADIGAN ARMY CENTER 9040 REID ST, ATTN: MCHJ-CLQ-C, TACOMA, WA 98431-1100
(253) 968-2252
(253) 968-3278
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/03/2009
Last updated
05/30/2013
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