MEDICARE: SHERIF YACOUB M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	35078539	OH
2	2085R0001X	Radiation Oncology Physician	MD432984	PA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1992555	OTHER	PA	HIGHMARK BLUE SHIELD
2	919374	OTHER	MD	CAREFIRST MD BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1568370	OTHER	PA	GATEWAY WMG
5	20069231	OTHER	PA	AMERIHEALTH MERCY-WMG
6	237322	OTHER	PA	UNISON-WMG
7	7971376	OTHER	PA	AETNA
8	211163	OTHER	PA	JOHNS HOPKINS
9	50074900	OTHER	PA	CAPITAL BLUE CROSS-WMG

NPI Number	:	1821099912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERIF YACOUB M.D.

Provider Business Mailing Address
First Line	:	3421 CONCORD RD
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-9001
Country	:	US
Telephone Number	:	717-741-8180
Fax Number	:	717-741-8196

Provider Business Practice Location Address
First Line	:	25 MONUMENT RD
Second Line	:	SUITE 94
City	:	YORK
State	:	PA
Zip	:	17403-5074
Country	:	US
Telephone Number	:	717-741-8180
Fax Number	:	717-741-8196

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	09/16/2020

10 UNION SQ E , BETH ISRAEL MED CTR- DEPT OF REHAB MEDICARE
NEW YORK, NY
10003-3314

Practice Phone: 212-420-2757
Practice Fax:

35 MONUMENT RD STE 201
YORK, PA
17403-5074