Provider Demographics
NPI:1508874504
Name:SHARABI, GHANEM (MD)
Entity Type:Individual
Prefix:
First Name:GHANEM
Middle Name:
Last Name:SHARABI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27560 HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-4505
Mailing Address - Country:US
Mailing Address - Phone:586-757-6400
Mailing Address - Fax:586-757-8400
Practice Address - Street 1:27560 HOOVER RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-4505
Practice Address - Country:US
Practice Address - Phone:586-757-6400
Practice Address - Fax:586-757-8400
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301060011207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics