Provider Demographics
NPI:1417199860
Name:SHAREEF, RAZIA NAINA (PA-C)
Entity Type:Individual
Prefix:
First Name:RAZIA
Middle Name:NAINA
Last Name:SHAREEF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:RAZIA
Other - Middle Name:
Other - Last Name:NAINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:900 CIRCLE 75 PKWY SE
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3035
Mailing Address - Country:US
Mailing Address - Phone:770-953-6929
Mailing Address - Fax:770-953-6972
Practice Address - Street 1:6300 HOSPITAL PKWY
Practice Address - Street 2:SUITE 400
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-1828
Practice Address - Country:US
Practice Address - Phone:678-205-4261
Practice Address - Fax:678-417-7187
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005692363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400003602Medicare PIN
GA202I974273Medicare PIN