Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 247102 | MA |
N | 207ND0900X | Dermatopathologist | 247102 | MA |
N | 207ND0900X | Dermatopathologist | 35 123477 | OH |
N | 207ND0900X | Dermatopathologist | 47322 | KY |
NPI | 1285812446 |
---|---|
Provider Name | Dr. Mohammed A Sharaf |
First Address | Boston, MA 02118-2371 |
Second Address | Boston, MA 02118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2008 |
Last Update Date | 21/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0103683 | (05) | OH |
201232180 | (05) | IN |
7100305330 | (05) | KY |
K151040 | (02) | KY |