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Individual
DR. SHARISSA BETH MABRY
Active
Individual
DR. SHARISSA BETH MABRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-39745
KS
207Q00000X
Family Medicine Physician
250857
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
250857
LICENSE #
NY
01
—
25MA09144300
MEDICAL LICENSE
NJ
Enumeration date
10/25/2008
Last updated
12/30/2023
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