Individual
SHERIF S ISMAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3201 W GORE BLVD, SUITE 105, LAWTON, OK 73505-6378
(580) 510-7077
(580) 510-7057
Mailing address
PO BOX 785, LAWTON, OK 73502
(580) 357-9984
(580) 357-3277
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22720
OK
208M00000X
Hospitalist Physician
22720
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100018480A
—
OK
01
—
100018480E
SOONERCARE
OK
01
—
607736500
DOL
OK
Enumeration date
09/19/2005
Last updated
02/06/2015
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