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Individual

MR. MUSADIQ JEDDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
15846 MANCHESTER RD, ELLISVILLE, MO 63011-2208
(636) 527-5074
Mailing address
15308 NOONING TREE CT, CHESTERFIELD, MO 63017-2482
(636) 675-3452

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
029516
MO
183500000X
Pharmacist
051-031888
IL
183500000X
Pharmacist
58060
TX
183500000X
Pharmacist
S018727
AZ

Other

Enumeration date
10/15/2011
Last updated
10/15/2011
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