Individual
MR. MICHAEL EUGENE MOFFETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3615 SANGANI BLVD, DIBERVILLE, MS 39540-8770
(228) 396-4617
Mailing address
3615 SANGANI BLVD, DIBERVILLE, MS 39540-8770
(228) 396-4617
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-6934
MS
Other
Enumeration date
11/07/2007
Last updated
11/07/2007
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