Provider Demographics
NPI:1043058423
Name:TESTERMAN, MARGARET GRACE (PHARMD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:GRACE
Last Name:TESTERMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 US HIGHWAY 82 W
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31793-8164
Mailing Address - Country:US
Mailing Address - Phone:229-386-0374
Mailing Address - Fax:
Practice Address - Street 1:1830 US HIGHWAY 82 W
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31793-8164
Practice Address - Country:US
Practice Address - Phone:229-386-0374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH034999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist