Individual
FAGA SAMDUMU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 INDEPENDENCE, COLUMBUS, MS 39710-5300
(662) 434-2168
(662) 434-2295
Mailing address
203 E PECAN ST UNIT B, HUTTO, TX 78634-3368
(512) 508-3369
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
56081
TX
Other
Enumeration date
06/11/2016
Last updated
06/11/2016
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