Provider Demographics
NPI:1851313688
Name:SHAREEF, MOHAMMED R (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:R
Last Name:SHAREEF
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 1:949 E LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2748
Mailing Address - Country:US
Mailing Address - Phone:614-445-7209
Mailing Address - Fax:614-656-7068
Practice Address - Street 1:949 E LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2748
Practice Address - Country:US
Practice Address - Phone:614-445-7209
Practice Address - Fax:614-656-7068
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04292000207R00000X
OH35047929207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0764098Medicaid
E51153Medicare UPIN
OH0764098Medicaid
OHSH0653072Medicare PIN