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NPI Code Detail

MEDICARE: CARL NDANGOH PHARM D

MEDICARE:   CARL  NDANGOH  PHARM D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist5302039573MI

General Provider Information

NPI Number : 1023631660
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARL NDANGOH PHARM D
Provider Business Mailing Address
First Line : 6413 BELHAVEN DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76123-2097
Country : US
Telephone Number : 817-791-8145
Fax Number :
Provider Business Practice Location Address
First Line : 2 TOWNE SQ
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48076-3769
Country : US
Telephone Number : 313-208-7376
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2020
Last Update Date : 05/18/2020

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Directions to “ CARL NDANGOH PHARM D” Practice Location

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