Healthcare Provider Details

I. General information

NPI: 1386443067
Provider Name (Legal Business Name): KASSEM SHARIF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BROOKLINE AVENUE, BETH ISRAEL DEACONESS MEDICAL CEN
BOSTON MA
02215
US

IV. Provider business mailing address

23 BUTTS COURT, APT 205
LEEDS LEEDS
LS15JS
GB

V. Phone/Fax

Practice location:
  • Phone: 617-667-8427
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberFL094
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: