Provider Demographics
NPI:1740726116
Name:AMICUS PHYSICIAN SERVICES, INC.
Entity type:Organization
Organization Name:AMICUS PHYSICIAN SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAFAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-480-0802
Mailing Address - Street 1:PO BOX 1983
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30722-1983
Mailing Address - Country:US
Mailing Address - Phone:706-271-0100
Mailing Address - Fax:
Practice Address - Street 1:175 VILLA NUEVA AVE NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-2595
Practice Address - Country:US
Practice Address - Phone:321-952-1818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty