Healthcare Provider Details

I. General information

NPI: 1093818213
Provider Name (Legal Business Name): SHERIF Z KAISER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 S CHURCH ST
BERRYVILLE VA
22611-1369
US

IV. Provider business mailing address

136 LINDEN DR SUITE 104
WINCHESTER VA
22601-6900
US

V. Phone/Fax

Practice location:
  • Phone: 540-955-4811
  • Fax: 540-955-0976
Mailing address:
  • Phone: 540-678-3588
  • Fax: 540-678-9025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101054240
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: