Provider Demographics
NPI:1609631126
Name:MUMUNEY, GANIYU (RPH)
Entity Type:Individual
Prefix:MR
First Name:GANIYU
Middle Name:
Last Name:MUMUNEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 LOCHWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-3931
Mailing Address - Country:US
Mailing Address - Phone:678-591-2976
Mailing Address - Fax:
Practice Address - Street 1:1207 MOUNT HERMON RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-5111
Practice Address - Country:US
Practice Address - Phone:410-749-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11046183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist