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1962507061
MARY S MISSAK
SOUTHAVEN, MS
NPI
1962507061
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Other Name
MARY SAMUEL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: MS 16715)
Enumeration Date
2006-09-13
Last Update Date
2007-07-08
Business Address
Ms. MARY S MISSAK M.D.
7680 AIRWAYS BLVD
SOUTHAVEN, MS 38671-5304
Phone number: 662-349-1999
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Mailing Address
Ms. MARY S MISSAK M.D.
7680 AIRWAYS BLVD
SOUTHAVEN, MS 38671-5304
Phone number: 662-349-1999
Copy
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