Provider Demographics
NPI:1154713360
Name:AYUK, ESTHER (MPH,RPH)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:AYUK
Suffix:
Gender:F
Credentials:MPH,RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 VETERANS MEMORIAL HWY SE
Mailing Address - Street 2:SUITE 128
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-2945
Mailing Address - Country:US
Mailing Address - Phone:770-714-2846
Mailing Address - Fax:404-699-0117
Practice Address - Street 1:1400 VETERANS MEMORIAL HWY SE
Practice Address - Street 2:SUITE 128
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-2945
Practice Address - Country:US
Practice Address - Phone:770-714-2846
Practice Address - Fax:404-699-0117
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH018086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist