Provider Demographics
NPI:1467751107
Name:EGUN, EVERETTE K (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EVERETTE
Middle Name:K
Last Name:EGUN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3334 PEACHTREE RD NE
Mailing Address - Street 2:UNTI#1006
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-6801
Mailing Address - Country:US
Mailing Address - Phone:404-861-6663
Mailing Address - Fax:
Practice Address - Street 1:3334 PEACHTREE RD NE
Practice Address - Street 2:UNTI#1006
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-6801
Practice Address - Country:US
Practice Address - Phone:404-861-6663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0246431835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy