Healthcare Provider Details

I. General information

NPI: 1639275316
Provider Name (Legal Business Name): SHERIF B. LABIB MD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 02/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LAHEY CLINIC 41 MALL RD.
BURLINGTON MA
01805-0001
US

IV. Provider business mailing address

LAHEY CLINIC 41 MALL RD.
BURLINGTON MA
01805-0001
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-8000
  • Fax: 781-744-8988
Mailing address:
  • Phone: 781-744-8002
  • Fax: 781-744-5261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number58750
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: