Provider Demographics
NPI:1437445830
Name:SHARUK, MAIA NAELA (MD)
Entity Type:Individual
Prefix:
First Name:MAIA
Middle Name:NAELA
Last Name:SHARUK
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 1:199 MASSACHUSETTS AVE
Mailing Address - Street 2:APT 803
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-3051
Mailing Address - Country:US
Mailing Address - Phone:781-249-5187
Mailing Address - Fax:
Practice Address - Street 1:147 MILK ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-4806
Practice Address - Country:US
Practice Address - Phone:617-654-7280
Practice Address - Fax:617-654-7280
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261645207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology