Individual
TASHAWN L. MUSTIFUL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
52579 HIGHWAY 51 S, INDEPENDENCE, LA 70443-2231
(225) 654-0522
Mailing address
PO BOX 1291, ZACHARY, LA 70791-1291
(225) 654-0522
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
024954
LA
Other
Enumeration date
06/08/2006
Last updated
07/08/2007
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