Active NPI
Wasim Odish
- Pharmacist
- Clarkston, MI
National Provider Identifier
1851924757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302032095
- Practice address
- 5529 Sashabaw Rd
Clarkston, MI 48346-3147 - Phone
- (248) 620-6663
- Fax
- (248) 620-0236
- NPI assigned
- Feb 19, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302032095 | MI | Primary |
Addresses
Primary practice location
5529 Sashabaw Rd
Clarkston, MI 48346-3147
Mailing address
5039 Village Square Cir
West Bloomfield, MI 48322-3383
Phone (248) 661-1934
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302032095 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582070400000",
"number": "1851924757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5039 VILLAGE SQUARE CIR",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483223383",
"telephone_number": "248-661-1934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5529 SASHABAW RD",
"city": "CLARKSTON",
"state": "MI",
"postal_code": "483463147",
"telephone_number": "248-620-6663",
"fax_number": "248-620-0236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODISH",
"first_name": "WASIM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-02-19",
"last_updated": "2020-02-19",
"certification_date": "2020-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302032095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarkston, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.