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1154060515
FARUKH ALI MIRZA
SOUTHAVEN, MS
NPI
1154060515
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-06-02
Last Update Date
2022-06-02
Business Address
FARUKH ALI MIRZA MD
7601 SOUTHCREST PKWY
SOUTHAVEN, MS 38671-4742
Phone number: 662-772-4696
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Mailing Address
FARUKH ALI MIRZA MD
7601 SOUTHCREST PKWY
SOUTHAVEN, MS 38671-4742
Phone number: 662-772-4696
Copy
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