Healthcare Provider Details

I. General information

NPI: 1356677447
Provider Name (Legal Business Name): MAHMOUD A. SHARAF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MAHMOUD SHARAF M.D.

II. Dates (important events)

Enumeration Date: 10/23/2009
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 CRAIG RD
EAU CLAIRE WI
54701-6118
US

IV. Provider business mailing address

1000 N OAK AVE
MARSHFIELD WI
54449-5703
US

V. Phone/Fax

Practice location:
  • Phone: 715-858-4500
  • Fax:
Mailing address:
  • Phone: 715-387-5511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number53387
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD-44058
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number10184
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: