Provider Demographics
NPI:1578030425
Name:RAGUINDIN, MICHELLE RAZON (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RAZON
Last Name:RAGUINDIN
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 1:20884 FREEDOM RUN DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-2497
Mailing Address - Country:US
Mailing Address - Phone:301-904-8375
Mailing Address - Fax:
Practice Address - Street 1:6135 ROOSEVELT HWY
Practice Address - Street 2:
Practice Address - City:WARM SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:31830-2757
Practice Address - Country:US
Practice Address - Phone:706-655-5418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH031954183500000X
MD25877183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist