MEDICARE: SHERIF GEORGE HARAWAY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	16741	NV
2	2084N0400X	Neurology Physician	2010009152	MO
3	2084P0301X	Brain Injury Medicine (Psychiatry & Neurology) Physician	16741	NV
4	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	16741	NV
5	208VP0014X	Interventional Pain Medicine Physician	036120927	IL
6	2084N0400X	Neurology Physician	036120927	IL

General Provider Information

NPI Number	:	1104029164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERIF GEORGE HARAWAY MD

Provider Business Mailing Address
First Line	:	1905 MCDANIEL ST STE 102
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-7170
Country	:	US
Telephone Number	:	702-294-0080
Fax Number	:

Provider Business Practice Location Address
First Line	:	2031 MCDANIEL ST STE 200
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-6312
Country	:	US
Telephone Number	:	702-294-0080
Fax Number	:	702-965-2220

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	04/30/2025

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