Provider Demographics
NPI:1457331746
Name:SHAREEF, SAMEERAH (CNM)
Entity Type:Individual
Prefix:
First Name:SAMEERAH
Middle Name:
Last Name:SHAREEF
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 JOLLY RD STE 220
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-6038
Mailing Address - Country:US
Mailing Address - Phone:517-975-1400
Mailing Address - Fax:517-975-1405
Practice Address - Street 1:2104 JOLLY RD STE 220
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-6038
Practice Address - Country:US
Practice Address - Phone:517-975-1400
Practice Address - Fax:517-975-1405
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704157353367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI252801OtherMCLAREN HEALTH PLAN
MI8300055OtherPHYSICIANS HEALTH PLAN
MI252801OtherHEALTH ADVANTAGE NETWORK
MI420875770OtherBLUE CROSS BLUE SHIELD
MI4397193Medicaid
MI252801OtherMCLAREN HEALTH PLAN