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Individual

EVANS SEREBOUR OPOKU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM. D.

Contact information

Practice address
1900 N MICHIGAN ST, PLYMOUTH, IN 46563-1046
(574) 935-5697
Mailing address
1110 FARM CREST DR APT 1B, MISHAWAKA, IN 46544-8960
(574) 952-0219

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
051297820
IL
183500000X
Pharmacist
Primary
26025605A
IN
183500000X
Pharmacist
64226
TX
183500000X
Pharmacist
82469
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26025605A
INDIANA LICENSING AGENCY
IN
Enumeration date
12/05/2020
Last updated
12/05/2020
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