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NPI Code Detail

MEDICARE: DR. SHARIFA M ABOU-MEDIENE MD

MEDICARE: DR. SHARIFA M ABOU-MEDIENE 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
1208000000XPediatrics Physician4301089798MI
2208D00000XGeneral Practice Physician78683GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G00233EOTHERGAMEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1750571956
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHARIFA M ABOU-MEDIENE MD
Provider Business Mailing Address
First Line : 7489 TROUTWOOD DR
Second Line : APT 3A
City : GRAND BLANC
State : MI
Zip : 48439-7503
Country : US
Telephone Number : 313-467-3630
Fax Number :
Provider Business Practice Location Address
First Line : 303 FRASER DR
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-3712
Country : US
Telephone Number : 912-877-2227
Fax Number : 912-877-2332
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2007
Last Update Date : 09/16/2020

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