Provider Demographics
NPI:1689605198
Name:SHARIFUZZAMAN, ABU ASAD MOHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:ABU ASAD
Middle Name:MOHAMMAD
Last Name:SHARIFUZZAMAN
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 1:1604 STANNARD TRL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-6385
Mailing Address - Country:US
Mailing Address - Phone:919-781-6016
Mailing Address - Fax:
Practice Address - Street 1:2300 RAMSEY ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-3856
Practice Address - Country:US
Practice Address - Phone:910-822-7903
Practice Address - Fax:910-822-7989
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-01243207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine