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NPI Code Detail

MEDICARE: DR. SHARIF EUSUFZAI M.D., PHD

MEDICARE: DR. SHARIF EUSUFZAI M.D., PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0300XGeriatric Medicine (Internal Medicine) Physician221248NY

General Provider Information

NPI Number : 1083719900
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHARIF EUSUFZAI M.D., PHD
Provider Business Mailing Address
First Line : 1055 ADA ST
Second Line : SOUTH BEXAR VA OUT PATIENT CLINIC
City : SAN ANTONIO
State : TX
Zip : 78223-1703
Country : US
Telephone Number : 210-358-5682
Fax Number : 210-358-5594
Provider Business Practice Location Address
First Line : 1055 ADA ST
Second Line : SOUTH BEXAR VA OUT PATIENT CLINIC
City : SAN ANTONIO
State : TX
Zip : 78223-1703
Country : US
Telephone Number : 210-358-5682
Fax Number : 210-358-5594
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 07/08/2007

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