Provider Demographics
NPI:1497264535
Name:MUZA, TALENT T (PHARMD)
Entity Type:Individual
Prefix:
First Name:TALENT
Middle Name:T
Last Name:MUZA
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 1:5119 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-6445
Mailing Address - Country:US
Mailing Address - Phone:706-650-1686
Mailing Address - Fax:
Practice Address - Street 1:5119 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-6445
Practice Address - Country:US
Practice Address - Phone:706-650-1686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH030237183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist