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General NPI Number Information
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NPI Number | 1497299507
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Entity Type | Individual
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Provider Name | GABRIEL ALIGWEKWE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/07/2016
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Last Update Date | 12/31/2019
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Provider Practice Location Address
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Address Line | 4404 HUGH HOWELL RD STE 17
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City | TUCKER
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State | GA
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Zip | 30084-4916
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Country | US
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Telephone | 470-508-0555
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Fax |
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Provider Business Mailing Address
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Address Line | 913 AUTUMN PATH WAY
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City | SNELLVILLE
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State | GA
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Zip | 30078-7752
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Country | US
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Telephone | 678-596-3761
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH029583
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License Number State | GA
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