Provider Demographics
NPI:1063643765
Name:GHOBRIAL, MICHAEL H (RPH, ESQ)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:GHOBRIAL
Suffix:
Gender:M
Credentials:RPH, ESQ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 NEW JERSEY AVE NW STE 600
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-2267
Mailing Address - Country:US
Mailing Address - Phone:202-383-7992
Mailing Address - Fax:202-383-7999
Practice Address - Street 1:300 NEW JERSEY AVE NW STE 600
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-2267
Practice Address - Country:US
Practice Address - Phone:202-383-7992
Practice Address - Fax:202-383-7999
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053567183500000X
IL051294560183500000X
VA0202212511183500000X
DCPH100002199183500000X
MD23612183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist