Provider Demographics
NPI:1477864346
Name:SHARIF, KEVIN R (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:R
Last Name:SHARIF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7455 W WASHINGTON AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4356
Mailing Address - Country:US
Mailing Address - Phone:702-878-0393
Mailing Address - Fax:702-258-3777
Practice Address - Street 1:1505 WIGWAM PKWY
Practice Address - Street 2:SUITE 330
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-8194
Practice Address - Country:US
Practice Address - Phone:702-878-0393
Practice Address - Fax:702-258-3777
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16654207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
52025806OtherUSME NUMBER