Individual
ANDREW WADE SUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
900 BOARDMAN DR, APT C 18, GALLUP, NM 87301-4774
(858) 204-4738
Mailing address
900 BOARDMAN DR, APT C18, GALLUP, NM 87301-4774
(858) 204-4738
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
56250
TX
183500000X
Pharmacist
Primary
RP00008351
NM
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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