Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 2020-00921 | NC |
N | 207V00000X | Obstetrician & Gynecologist | 65497 | WI |
NPI | 1003171539 |
---|---|
Provider Name | Amr Sherif Mohamed Rifaa El Haraki |
First Address | Winston Salem, NC 27157-0001 |
Second Address | Winston Salem, NC 27157-4110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2012 |
Last Update Date | 23/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100057849 | (05) | WI |