Provider Demographics
NPI:1285011635
Name:SHARIFMOHAMED, FATIMA AMIR (MD)
Entity Type:Individual
Prefix:
First Name:FATIMA
Middle Name:AMIR
Last Name:SHARIFMOHAMED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FADUMA
Other - Middle Name:AMIR
Other - Last Name:SHARIFMOHAMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 CENTRACARE CIR STE 2300
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-5000
Mailing Address - Country:US
Mailing Address - Phone:320-654-3630
Mailing Address - Fax:320-229-5142
Practice Address - Street 1:1900 CENTRACARE CIR STE 2300
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303
Practice Address - Country:US
Practice Address - Phone:320-654-3630
Practice Address - Fax:320-229-5142
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MN65702207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program