Individual
SIAMAK MOLLAEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
BUREAU OF INDIAN AFFAIR ROUTE 125, PINEHILL, NM 87357
(505) 775-3933
Mailing address
BUREAU OF INDIAN AFFAIR ROUTE 125, PINEHILL, NM 87357
(505) 775-3933
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S023980
AZ
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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