MEDICARE: SHEREAF WALID WALID M.D.

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	207P00000X	Emergency Medicine Physician	036154487	IL
2	207P00000X	Emergency Medicine Physician	4301094889	MI

General Provider Information

NPI Number	:	1720217979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEREAF WALID WALID M.D.

Provider Business Mailing Address
First Line	:	1247 WOODWARD AVE APT 708
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48226-2030
Country	:	US
Telephone Number	:	917-334-2269
Fax Number	:

Provider Business Practice Location Address
First Line	:	1247 WOODWARD AVE
Second Line	:	APT 708
City	:	DETROIT
State	:	MI
Zip	:	48226-2025
Country	:	US
Telephone Number	:	917-334-2269
Fax Number	:

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

Provider Enumeration Date	:	07/09/2009
Last Update Date	:	03/05/2026

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