MEDICARE: MOHAMED F ALSHAREDI MD

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
1	207RH0003X	Hematology & Oncology Physician	54566	KY
2	207RX0202X	Medical Oncology Physician	TP671	KY
3	207RX0202X	Medical Oncology Physician	25459	WV
4	207RX0202X	Medical Oncology Physician	54566	KY

General Provider Information

NPI Number	:	1396059705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED F ALSHAREDI MD

Provider Business Mailing Address
First Line	:	2195 HARRODSBURG RD FL 2
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3516
Country	:	US
Telephone Number	:	859-258-4673
Fax Number	:	859-258-6539

Provider Business Practice Location Address
First Line	:	2195 HARRODSBURG RD FL 2
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3516
Country	:	US
Telephone Number	:	859-258-4673
Fax Number	:	859-258-6539

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2010
Last Update Date	:	01/06/2021

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