Provider Demographics
NPI:1275586851
Name:EL SHARKAWY, TAREK A (MD)
Entity Type:Individual
Prefix:
First Name:TAREK
Middle Name:A
Last Name:EL SHARKAWY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 INDUSTRIAL RD STE 5
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3736
Mailing Address - Country:US
Mailing Address - Phone:508-473-1480
Mailing Address - Fax:
Practice Address - Street 1:12 UXBRIDGE RD STE 201
Practice Address - Street 2:
Practice Address - City:MENDON
Practice Address - State:MA
Practice Address - Zip Code:01756-1095
Practice Address - Country:US
Practice Address - Phone:508-634-6620
Practice Address - Fax:508-634-6813
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231637207R00000X
ME012815207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME309290099Medicaid
ME309290099Medicaid
MEMM7518Medicare PIN