Individual
DR. MAYA ANGELA TATUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
701 N WALES RD, NORTH WALES, PA 19454-2754
(215) 412-8709
Mailing address
624 S CLIFTON ST, PHILADELPHIA, PA 19147-1921
(267) 773-8651
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPI005647
PA
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RP441117
PA
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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