Provider Demographics
NPI:1407927130
Name:SHIRIF, KHALID M (MD)
Entity Type:Individual
Prefix:DR
First Name:KHALID
Middle Name:M
Last Name:SHIRIF
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 1:105 N PASADENA ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5013
Mailing Address - Country:US
Mailing Address - Phone:480-268-2670
Mailing Address - Fax:480-268-2671
Practice Address - Street 1:105 N PASADENA ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5013
Practice Address - Country:US
Practice Address - Phone:480-268-2670
Practice Address - Fax:480-268-2671
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ382152086H0002X, 207QG0300X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086H0002XAllopathic & Osteopathic PhysiciansSurgeryHospice and Palliative Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine