Provider Demographics
NPI:1831934405
Name:SHARIF, LUKHMAN
Entity type:Individual
Prefix:
First Name:LUKHMAN
Middle Name:
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 1:1521 7TH ST S APT H309
Mailing Address - Street 2:
Mailing Address - City:WAITE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:56387-1734
Mailing Address - Country:US
Mailing Address - Phone:207-344-9364
Mailing Address - Fax:
Practice Address - Street 1:1627 WHITE BEAR AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-1609
Practice Address - Country:US
Practice Address - Phone:651-278-7319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician