Basic Information
| Provider Information | |||||||||
| NPI: | 1366042285 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHAREEF | ||||||||
| FirstName: | SUMAIYA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 611 CALDER WAY | ||||||||
| Address2: | |||||||||
| City: | SEVERN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211442781 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4433883774 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9750 REISTERSTOWN RD STE A | ||||||||
| Address2: | |||||||||
| City: | OWINGS MILLS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211174147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4433940987 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2020 | ||||||||
| LastUpdateDate: | 10/29/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 18538 | MD | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.