MEDICARE: KHALID K AL-SHARIF 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	207R00000X	Internal Medicine Physician	042161	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	110204191	OTHER	GA	MEDICARE RAILROAD #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437105558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHALID K AL-SHARIF MD

Provider Business Mailing Address
First Line	:	1531 WATSON BLVD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-3449
Country	:	US
Telephone Number	:	478-599-0110
Fax Number	:	478-599-0001

Provider Business Practice Location Address
First Line	:	1531 WATSON BLVD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-3449
Country	:	US
Telephone Number	:	478-599-0110
Fax Number	:	478-599-0001

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	06/30/2009

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Directions to “ KHALID K AL-SHARIF MD” Practice Location

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