Provider Demographics
NPI:1851357164
Name:SHARIF, MOHAMMAD A (DPM)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:A
Last Name:SHARIF
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 CIRCLE 75 PKWY.
Mailing Address - Street 2:STE. 900
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3084
Mailing Address - Country:US
Mailing Address - Phone:678-426-2171
Mailing Address - Fax:404-446-1957
Practice Address - Street 1:550 PEACHTREE STREET
Practice Address - Street 2:1960
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2225
Practice Address - Country:US
Practice Address - Phone:404-589-1330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD000944213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA375368511AMedicaid
GAP00032416Medicare PIN
GA48SCCLVMedicare PIN
GAU95432Medicare UPIN
GA1103400014Medicare NSC