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SUSAN CORRINE SHARIFI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1739 N 4TH ST, TERRE HAUTE, IN 47804-4002
(812) 242-3125
(812) 242-3446
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 242-3125
(812) 242-3446

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01043795A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000089650
ANTHEM
01
130013869
RAILROAD MCARE PALAMETTO
05
200036030
IN
05
200036030A
IN
05
200036030S
IN
01
P00834680
RAILROAD MEDICARE
IN
Enumeration date
08/31/2006
Last updated
08/18/2010
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