Provider Demographics
NPI:1093830309
Name:WASANYI, DAVID MUSISI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MUSISI
Last Name:WASANYI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 RUBENS CIR
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-8303
Mailing Address - Country:US
Mailing Address - Phone:540-327-6140
Mailing Address - Fax:
Practice Address - Street 1:443 RUBENS CIR
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25403-8303
Practice Address - Country:US
Practice Address - Phone:540-327-6140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2009-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006943183500000X
UT51056551701183500000X
VA02022081481835P1200X
MD188011835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy