Provider Demographics
NPI:1821598939
Name:ROSHDY, MAICHEL
Entity Type:Individual
Prefix:
First Name:MAICHEL
Middle Name:
Last Name:ROSHDY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2513 W CUTHBERT AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-5624
Mailing Address - Country:US
Mailing Address - Phone:215-681-6394
Mailing Address - Fax:432-689-0653
Practice Address - Street 1:2751 N COUNTY RD W
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79764-1665
Practice Address - Country:US
Practice Address - Phone:432-333-1591
Practice Address - Fax:432-335-0839
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX509841835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist