Healthcare Provider Details

I. General information

NPI: 1134386592
Provider Name (Legal Business Name): SHARIF ASHANTI ABDUS-SALAAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 N LEE TREVINO DR STE B
EL PASO TX
79936-2116
US

IV. Provider business mailing address

1264 WESLEY DR STE 302
MEMPHIS TN
38116-6445
US

V. Phone/Fax

Practice location:
  • Phone: 915-533-7465
  • Fax: 915-534-1185
Mailing address:
  • Phone: 901-260-2072
  • Fax: 901-260-2077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number45803
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number21698
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberW0354
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA108853
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: