Basic Information
| Provider Information | |||||||||
| NPI: | 1144846999 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHARIF | ||||||||
| FirstName: | SURUR | ||||||||
| MiddleName: | NADER | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD, MBBS | ||||||||
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| Mailing Information | |||||||||
| Address1: | SONORA SUNSET APARTMENTS 3751 W 24TH ST, YUMA, AZ 85364 | ||||||||
| Address2: | APARTMENT # E236 | ||||||||
| City: | YUMA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2026317176 | ||||||||
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| Practice Location | |||||||||
| Address1: | YUMA REGIONAL MEDICAL CENTER 2400 AVENUE A | ||||||||
| Address2: | |||||||||
| City: | YUMA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9283361290 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2020 | ||||||||
| LastUpdateDate: | 06/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 1908R77911 | AZ | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.