Provider Demographics
NPI:1164182804
Name:ASHMAWY, MOHAMED G (PHARMD)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:G
Last Name:ASHMAWY
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 1:1142 APPLETREE LN
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-3917
Mailing Address - Country:US
Mailing Address - Phone:224-578-0289
Mailing Address - Fax:
Practice Address - Street 1:353 E 6TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1609
Practice Address - Country:US
Practice Address - Phone:814-455-2910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302414005183500000X
PARP456411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP456411OtherPENNSYLVANIA BOARD OF PHARMACY
MI5302414005OtherMICHIGAN BOARD OF PHARMACY