Provider Demographics
NPI:1952531121
Name:SHERIF NASEF, MD, PLLC
Entity Type:Organization
Organization Name:SHERIF NASEF, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERIF
Authorized Official - Middle Name:
Authorized Official - Last Name:NASEF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-279-6503
Mailing Address - Street 1:1755 AIRWAY AVE
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-3620
Mailing Address - Country:US
Mailing Address - Phone:928-681-1234
Mailing Address - Fax:928-681-1811
Practice Address - Street 1:1755 AIRWAY AVE
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-3620
Practice Address - Country:US
Practice Address - Phone:928-681-1234
Practice Address - Fax:928-681-1811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27906207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty