Healthcare Provider Details

I. General information

NPI: 1801008677
Provider Name (Legal Business Name): STEVE MOK PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE PHARMACY
ATLANTA GA
30308-2208
US

IV. Provider business mailing address

550 PEACHTREE ST NE PHARMACY
ATLANTA GA
30308-2208
US

V. Phone/Fax

Practice location:
  • Phone: 404-686-8904
  • Fax: 404-686-2177
Mailing address:
  • Phone: 404-686-8904
  • Fax: 404-686-2177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRPH025366
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: