Provider Demographics
NPI:1285233635
Name:ALSHARKAWI, MAHMOUD (RPH)
Entity type:Individual
Prefix:
First Name:MAHMOUD
Middle Name:
Last Name:ALSHARKAWI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4698 S WHITNALL AVE
Mailing Address - Street 2:
Mailing Address - City:ST FRANCIS
Mailing Address - State:WI
Mailing Address - Zip Code:53235-6052
Mailing Address - Country:US
Mailing Address - Phone:414-763-0660
Mailing Address - Fax:
Practice Address - Street 1:4698 S WHITNALL AVE
Practice Address - Street 2:
Practice Address - City:ST FRANCIS
Practice Address - State:WI
Practice Address - Zip Code:53235-6052
Practice Address - Country:US
Practice Address - Phone:414-763-0660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-17
Last Update Date:2020-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16141-401835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist