Provider Demographics
NPI:1265317978
Name:ISHOW, JONATHAN JONAH
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:JONAH
Last Name:ISHOW
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 1:45063 NORTHPORT DR APT 1307
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-3914
Mailing Address - Country:US
Mailing Address - Phone:586-383-3457
Mailing Address - Fax:
Practice Address - Street 1:43893 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1119
Practice Address - Country:US
Practice Address - Phone:586-685-1346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53024178131835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist