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NPI Code Detail

MEDICARE: MAY GANOOM

MEDICARE: MAY GANOOM
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
1183500000XPharmacist5302033622MI

General Provider Information

NPI Number : 1144795063
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAY GANOOM
Provider Business Mailing Address
First Line : 1685 BALDWIN AVE STE 100
Second Line :
City : PONTIAC
State : MI
Zip : 48340-1242
Country : US
Telephone Number : 248-230-2237
Fax Number :
Provider Business Practice Location Address
First Line : 1685 BALDWIN AVE STE 100
Second Line :
City : PONTIAC
State : MI
Zip : 48340-1242
Country : US
Telephone Number : 248-230-2237
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2018
Last Update Date : 07/09/2020

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Directions to “ MAY GANOOM ” Practice Location

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