Provider Demographics
NPI:1336716323
Name:SHAKEEL SHAREEF, MD PLLC
Entity Type:Organization
Organization Name:SHAKEEL SHAREEF, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAKEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAREEF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-353-1903
Mailing Address - Street 1:6815 BRADFORD CIR
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-4713
Mailing Address - Country:US
Mailing Address - Phone:585-233-8449
Mailing Address - Fax:
Practice Address - Street 1:1850 TOWN CENTER PKWY STE 301
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3300
Practice Address - Country:US
Practice Address - Phone:571-353-1903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center