Provider Demographics
NPI:1043227556
Name:SHARBEK, MOHAMMAD FATHI (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:FATHI
Last Name:SHARBEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:M
Other - Middle Name:F
Other - Last Name:SHARBEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3600 KOLBE RD
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1654
Mailing Address - Country:US
Mailing Address - Phone:440-960-7301
Mailing Address - Fax:440-960-7303
Practice Address - Street 1:3600 KOLBE RD STE 103
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1652
Practice Address - Country:US
Practice Address - Phone:440-960-7301
Practice Address - Fax:440-960-7303
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.043675174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0424115Medicaid
OH0424115Medicaid
OHA79317Medicare UPIN