Provider Demographics
NPI:1255352738
Name:SHARAF, BARRY L (MD)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:L
Last Name:SHARAF
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 1:2 DUDLEY ST
Mailing Address - Street 2:SUITE 360
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3236
Mailing Address - Country:US
Mailing Address - Phone:404-444-8540
Mailing Address - Fax:401-444-8158
Practice Address - Street 1:2 DUDLEY ST
Practice Address - Street 2:SUITE 360
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3236
Practice Address - Country:US
Practice Address - Phone:404-444-8540
Practice Address - Fax:401-444-8158
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD07556207RC0000X
RI07556207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9006506Medicaid
RI007056747Medicare ID - Type Unspecified
RID87123Medicare UPIN