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Individual

DR. MARDI GRAS NANYONGO ETCHI-BANYI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
612 SAINT JOSEPH AVE, BERRIEN SPRINGS, MI 49103-1603
(301) 377-6096
(269) 473-2566
Mailing address
9766 ROSEHILL RD APT I51, BERRIEN SPRINGS, MI 49103-2221
(301) 377-6096
(269) 473-2566

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302047702
MI
374U00000X
Home Health Aide

Other

Enumeration date
10/15/2012
Last updated
04/17/2019
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