Healthcare Provider Details

I. General information

NPI: 1295957470
Provider Name (Legal Business Name): SHERIF B WASSEF MD, MS, FRCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SHERIF BOTROS MIKHAIL WASSEF MD, MS, FRCS

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1111
DULUTH GA
30096-0020
US

IV. Provider business mailing address

PO BOX 1111
DULUTH GA
30096-0020
US

V. Phone/Fax

Practice location:
  • Phone: 860-655-4037
  • Fax: 860-666-4932
Mailing address:
  • Phone: 860-655-4037
  • Fax: 860-666-4932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME177186
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD069654L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD069654L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: