Provider Demographics
NPI:1154316966
Name:SHARFMAN, AVRAHAM (PSYD)
Entity Type:Individual
Prefix:
First Name:AVRAHAM
Middle Name:
Last Name:SHARFMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2007
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49501-2007
Mailing Address - Country:US
Mailing Address - Phone:616-532-8000
Mailing Address - Fax:616-532-7230
Practice Address - Street 1:7550 HOHMAN AVE
Practice Address - Street 2:STE 1200A
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1060
Practice Address - Country:US
Practice Address - Phone:616-532-8000
Practice Address - Fax:616-532-7230
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN200405508A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL90000854OtherBCBSIL
IN100165290Medicaid
IN228740Medicare Oscar/Certification
IL90000854OtherBCBSIL
IN408460OMedicare PIN