Provider Demographics
NPI:1821099912
Name:YACOUB, SHERIF (MD)
Entity Type:Individual
Prefix:
First Name:SHERIF
Middle Name:
Last Name:YACOUB
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-741-8180
Mailing Address - Fax:717-741-8196
Practice Address - Street 1:25 MONUMENT RD
Practice Address - Street 2:SUITE 94
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5074
Practice Address - Country:US
Practice Address - Phone:717-741-8180
Practice Address - Fax:717-741-8196
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350785392085R0001X
PAMD4329842085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1992555OtherHIGHMARK BLUE SHIELD
MD919374OtherCAREFIRST MD BCBS
PA102018947Medicaid
PA1568370OtherGATEWAY WMG
PA20069231OtherAMERIHEALTH MERCY-WMG
PA237322OtherUNISON-WMG
PA7971376OtherAETNA
PA211163OtherJOHNS HOPKINS
PA50074900OtherCAPITAL BLUE CROSS-WMG
PA237322OtherUNISON-WMG
PAH34895Medicare UPIN
PA118171Medicare PIN