Provider Demographics
NPI:1417908898
Name:SHERIF, KATHERINE D (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:D
Last Name:SHERIF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 WALNUT ST FL 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-3505
Mailing Address - Country:US
Mailing Address - Phone:215-503-4779
Mailing Address - Fax:215-503-4922
Practice Address - Street 1:700 WALNUT ST FL 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106
Practice Address - Country:US
Practice Address - Phone:215-503-4779
Practice Address - Fax:215-503-4922
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051480L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001514349Medicaid
PA0015143490007Medicaid
PA001514349Medicaid
PA688657PAGMedicare PIN