Healthcare Provider Details

I. General information

NPI: 1386141000
Provider Name (Legal Business Name): NEMATULLAH SHARAF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 09/26/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 PARK ST
HYANNIS MA
02601-5230
US

IV. Provider business mailing address

27 PARK ST
HYANNIS MA
02601-5230
US

V. Phone/Fax

Practice location:
  • Phone: 508-771-1800
  • Fax:
Mailing address:
  • Phone: 508-771-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number292394
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: