Provider Demographics
NPI:1356644348
Name:MUMUNEY, LAWAL O (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:LAWAL
Middle Name:O
Last Name:MUMUNEY
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10276 SOUTHERN MARYLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-3028
Mailing Address - Country:US
Mailing Address - Phone:410-257-0392
Mailing Address - Fax:410-257-0920
Practice Address - Street 1:10276 SOUTHERN MARYLAND BLVD
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-3028
Practice Address - Country:US
Practice Address - Phone:410-257-0392
Practice Address - Fax:410-257-0920
Is Sole Proprietor?:No
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18877183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist