Provider Demographics
NPI:1750318606
Name:EL-SALAWY, SHERIF M (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERIF
Middle Name:M
Last Name:EL-SALAWY
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:PO BOX 3266
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32085-3266
Mailing Address - Country:US
Mailing Address - Phone:904-819-4602
Mailing Address - Fax:904-819-4426
Practice Address - Street 1:486 TOWN PLAZA AVE STE 440
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32081-5142
Practice Address - Country:US
Practice Address - Phone:904-819-4242
Practice Address - Fax:904-819-4243
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY272366207RG0300X
FLME86538207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254065700Medicaid
FL254065700Medicaid
FLK0329Medicare ID - Type UnspecifiedGROUP