Healthcare Provider Details

I. General information

NPI: 1245293349
Provider Name (Legal Business Name): SHERIF FIKRY ALGENDY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 10/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 PLEASANT ST SUITE 2N
WEST BRIDGEWATER MA
02379-1506
US

IV. Provider business mailing address

22 PLEASANT ST 2N
WEST BRIDGEWATER MA
02379-1506
US

V. Phone/Fax

Practice location:
  • Phone: 508-436-2555
  • Fax: 508-436-2556
Mailing address:
  • Phone: 508-436-2555
  • Fax: 508-436-2556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number223072
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number223072
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: