Provider Demographics
NPI:1770318339
Name:SHARIF, MOHAMED JAMA
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:JAMA
Last Name:SHARIF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3119 RUSSELL AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-1018
Mailing Address - Country:US
Mailing Address - Phone:612-540-8468
Mailing Address - Fax:
Practice Address - Street 1:3119 RUSSELL AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-1018
Practice Address - Country:US
Practice Address - Phone:612-540-8468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service