Healthcare Provider Details

I. General information

NPI: 1619268232
Provider Name (Legal Business Name): MICHAEL ANWAR GHATTAS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13201 RITTENHOUSE DR
MIDLOTHIAN VA
23112-6245
US

IV. Provider business mailing address

13201 RITTENHOUSE DR
MIDLOTHIAN VA
23112-6245
US

V. Phone/Fax

Practice location:
  • Phone: 804-763-5403
  • Fax:
Mailing address:
  • Phone: 804-763-5403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202208232
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0202208232
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: