DR. MICHAEL DWAYNE ROE (NPI# 1750543203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750543203 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL DWAYNE ROE |
| Credential | PHARM.D. |
| Practice Address |
1061 Harmon Ave Fort Stewart GA 31314-5641 |
| Practice Telephone | (912) 435-6965 |
| Mailing Telephone | (912) 435-6965 |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2017-08-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
PS 36556 | FL | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALIT | PS36556 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134475452 | Michael Roe | Counselor | 1200 Ring Rd, 2454, Calumet City, IL 60409-7200 | 2012-07-24 |
| Street Address |
1061 HARMON AVE |
| City | FORT STEWART |
| State | GA |
| Zip Code | 31314-5641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871596486 | Donald E Shackleford | Obstetrics & Gynecology | 1061 Harmon Ave, Fort Stewart, GA 31314 | 2005-05-27 |
| 1619575081 | Rudy Noel Torres Negron | Social Worker | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-10-16 |
| 1629675434 | Darryl B Moore | Counselor | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-10-05 |
| 1093330268 | Lesheia Tasker | Technician, Other | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-06-12 |
| 1770111270 | Kendal Padgett | Physical Therapist | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-30 |
| 1104452218 | Tiffany L Stark | Physician Assistant | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-20 |
| 1396371035 | Alicia Nichole Hasquin | Physician Assistant | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-13 |
| 1407481492 | Matthew Douglas Lueders | Student in an Organized Health Care Education/Training Program | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-10 |
| 1316572308 | Seth Ravid | Student in an Organized Health Care Education/Training Program | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-10 |
| 1487289526 | Huon Sharpe | Student in an Organized Health Care Education/Training Program | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932733995 | Heather Ziccarelli Deneen | Dietitian, Registered | 441 Bultman Ave, 1183, Fort Stewart, GA 31314 | 2020-02-28 |
| 1073099826 | Ross Emerick | Dentist | 351 West 6th Street, Fort Stewart, GA 31314 | 2018-07-16 |
| 1184154742 | Roland Garcia | Dentist | 351 W 6th St Bldg 440, Ft Stewart, GA 31314 | 2017-06-15 |
| 1548613045 | Sylvia Mclean | Dental Hygienist | 343 Vanguard Road, Fort Stewart, GA 31314 | 2016-07-20 |
| 1407209257 | David Wald Jr. | Dental Hygienist | 305 Vanguard Rd. Bldg 8335, Fort Stewar, GA 31314 | 2016-07-18 |
| 1376995415 | Alisha Potter | Dental Assistant | 305 Vangurard Road, Ft Stewart, GA 31314 | 2016-07-12 |
| 1538511068 | Brandi Harris | Dental Assistant | 305 Vanguard Rd, Ft Stewart, GA 31314 | 2016-07-08 |
| 1548612088 | Adrian Cuthbert | Dental Assistant | 305 Vanguard Road, Bldg 8435, Fort Stewart, GA 31314 | 2016-07-08 |
| 1841642386 | Beverly Lynn Berry | Dental Assistant | 306 Vanguard Road Bldg 8435, Fort Stewart, GA 31314 | 2016-07-08 |
| 1740630060 | Anjanette Nicole' Brown | Dental Assistant | 706 Warriors Rd, Building 2115, Fort Stewart, GA 31314 | 2016-06-17 |
| Find all providers in zip 31314 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841820586 | Dante Oliver | Pharmacist | Winn Army Community Hospital, 1061 Harmon Ave, Fort Stewart, GA 31314 | 2020-01-22 |
| 1063888089 | Erin M Sheehan | Pharmacist | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2015-08-13 |
| 1417331687 | Terica Shellene Johnson | Pharmacist | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2015-07-16 |
| 1831457704 | Laura R Kennedy | Pharmacist | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2012-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306445747 | Hiep Hoang Do | Pharmacist | 801 Burns Estates Dr, Lilburn, GA 30047-3484 | 2020-10-17 |
| 1518565902 | Edward Edeh | Pharmacist | 1232 South Hairstoh Road, Stone Mountain, GA 30088 | 2020-10-16 |
| 1548868342 | Jackson Gathuru Ngugi | Pharmacist | 193 Anniversary Ln, Acworth, GA 30102-2045 | 2020-10-14 |
| 1568086494 | Lynn Berner Marshall | Pharmacist | 3823 Club Forest Dr, Peachtree Corners, GA 30092-2369 | 2020-06-06 |
| 1295357325 | Rhonda Ireland | Pharmacist | 125 Main Street Marketplace, Cartersville, GA 30120 | 2020-05-12 |
| 1073132676 | Khushboo S Rhodes | Pharmacist | 3101 Roswell Rd Ste 132, Marietta, GA 30062-5523 | 2020-04-14 |
| 1194354647 | Deanna W Mcewen | Pharmacist | 1720 Epps Bridge Road, Athens, GA 30606-6132 | 2020-04-06 |
| 1104452663 | Latrena Solomon | Pharmacist | 1750 Highway 138 E, Stockbridge, GA 30281-2810 | 2020-03-17 |
| 1497389597 | Rx Healthcare Ltd | Pharmacist | 2136 W Park Ct Ste I, Stone Mountain, GA 30087-3528 | 2020-02-27 |
| 1972136273 | Shannon Sulik | Pharmacist | 774 Highway 96, Bonaire, GA 31005-3300 | 2020-02-15 |
| Find all providers with the same taxonomy | ||||
| City | FORT STEWART |
| Zip Code | 31314 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.