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General NPI Number Information
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NPI Number | 1629464243
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Entity Type | Individual
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Provider Name | MOHAMED OMER SHARIF M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2015
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 1200 RALSTON AVE
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City | DEFIANCE
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State | OH
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Zip | 43512-1396
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Country | US
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Telephone | 419-783-6955
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Fax |
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Provider Business Mailing Address
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Address Line | 9003 GREEK PALACE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89178-7574
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Country | US
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Telephone | 702-882-2267
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 73700
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A167675
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2019-02152
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License Number State | NC
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