MEDICARE: MR. JAMIEL SHARIEF HAFIZ LPA, LAC

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	171100000X	Acupuncturist	UO1334	MD
2	363AM0700X	Medical Physician Assistant	C0004363	MD

General Provider Information

NPI Number	:	1730201773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMIEL SHARIEF HAFIZ LPA, LAC

Provider Business Mailing Address
First Line	:	14 STONE SPRING CT
Second Line	:
City	:	CATONSVILLE
State	:	MD
Zip	:	21228-5367
Country	:	US
Telephone Number	:	410-227-4939
Fax Number	:	877-735-6141

Provider Business Practice Location Address
First Line	:	8838 COURT AVE
Second Line	:	SUITE 101
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-4614
Country	:	US
Telephone Number	:	410-227-4939
Fax Number	:	877-735-6141

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

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	01/05/2022

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