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1710916564
WAKKAS TAYARA
GULFPORT, MS
NPI
1710916564
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RC0000X Internal Medicine, Cardiovascular Disease
(Licence: MS 18677)
Enumeration Date
2006-07-02
Last Update Date
2010-01-14
Business Address
-- WAKKAS TAYARA M.D.
1391 BROAD AVE
GULFPORT, MS 39501-2419
Phone number: 228-392-7429
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Mailing Address
-- WAKKAS TAYARA M.D.
1720A MEDICAL PARK DR SUITE 340
BILOXI, MS 39532-2129
Phone number: 228-392-7429
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