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Individual

DR. OUDALOM SOUMPHOLPHAKDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D, PH.C

Contact information

Practice address
11001 MENAUL BLVD NE, ALBUQUERQUE, NM 87112-2432
(505) 200-3440
(505) 200-3436
Mailing address
11001 MENAUL BLVD NE, ALBUQUERQUE, NM 87112-2432
(505) 200-3440
(505) 200-3436

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00006608
NM
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PC00000149
NM

Other

Enumeration date
06/25/2008
Last updated
07/18/2014
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