Organization
SHIFA MEDICINE & INFECTIOUS DISEASES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD FAZALULLAH SHARIEF M.D (SOLE OWNER)
(508) 981-6279
Entity
Organization
Contact information
Practice address
1705 TARBORO ST SW, WILSON, NC 27893-3428
(508) 981-6279
Mailing address
5509 SOUTHERN CROSS AVE, RALEIGH, NC 27606-4015
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
2010-00192
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5916722
—
NC
Enumeration date
08/04/2011
Last updated
08/04/2011
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