Individual
DR. FAIZUDDIN SHAREEF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
2640 HAMSTROM RD, PORTAGE, IN 46368-3832
(219) 762-4423
Mailing address
2640 HAMSTROM RD, PORTAGE, IN 46368-3832
(219) 762-4423
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02003711A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200990690
—
IN
Enumeration date
09/07/2007
Last updated
09/29/2011
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