MR. Mansuru Mustapha, PHYSICIAN ASSISTANT
NPI #1013159193 in Jblm, Washington
Provider Information
- NPI Number
- 1013159193
- Entity Type
- Individual
- Name
- MR. Mansuru Mustapha, PHYSICIAN ASSISTANT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PHYSICIAN ASSISTANT
- Enumeration Date
- Apr 3, 2009
- Last Updated
- May 30, 2013
Practice Location
- Address
- 9119 MIL PARK AVE
- Address 2
- WINDER CLINIC -RAIDER CLINIC
- City
- Jblm
- State
- Washington
- ZIP Code
- 98433-1100
- Phone
- (253) 477-0800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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