Provider Demographics
NPI:1083719900
Name:EUSUFZAI, SHARIF (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARIF
Middle Name:
Last Name:EUSUFZAI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 ADA ST
Mailing Address - Street 2:SOUTH BEXAR VA OUT PATIENT CLINIC
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-1703
Mailing Address - Country:US
Mailing Address - Phone:210-358-5682
Mailing Address - Fax:210-358-5594
Practice Address - Street 1:1055 ADA ST
Practice Address - Street 2:SOUTH BEXAR VA OUT PATIENT CLINIC
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-1703
Practice Address - Country:US
Practice Address - Phone:210-358-5682
Practice Address - Fax:210-358-5594
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221248207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine