Individual
DR. MARK KWAME OSEBRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
120 US-171, MOSS BLUFF, LA 70611
(337) 855-4848
Mailing address
807 WALTERS ST APT 21, LAKE CHARLES, LA 70607-4643
(973) 738-6762
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
048347
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048347
LOUISIAN BOARD OF PHARMACY
LA
Enumeration date
01/23/2018
Last updated
01/23/2018
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