Healthcare Provider Details

I. General information

NPI: 1811085152
Provider Name (Legal Business Name): HISHAM M.F. SHERIF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 06/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD SUITE 1E50
NEWARK DE
19805-7170
US

IV. Provider business mailing address

4755 OGLETOWN STANTON RD SUITE 1E50
NEWARK DE
19805-7170
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-1980
  • Fax: 302-733-1986
Mailing address:
  • Phone: 302-733-1980
  • Fax: 302-733-1986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberC10007033
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: