Provider Demographics
NPI:1720590631
Name:SHARIFF, FAHD MOHAMED
Entity Type:Individual
Prefix:
First Name:FAHD
Middle Name:MOHAMED
Last Name:SHARIFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26237 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LATHRUP VILLAGE
Mailing Address - State:MI
Mailing Address - Zip Code:48076-4546
Mailing Address - Country:US
Mailing Address - Phone:248-728-4960
Mailing Address - Fax:248-728-4962
Practice Address - Street 1:26237 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LATHRUP VILLAGE
Practice Address - State:MI
Practice Address - Zip Code:48076-4546
Practice Address - Country:US
Practice Address - Phone:248-728-4960
Practice Address - Fax:248-728-4962
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician