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Individual

BUTHEINAH A AL-SHARAFI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4190 24TH AVE, SUITE:201, FORT GRATIOT, MI 48059-3882
(810) 989-7478
(810) 989-7644
Mailing address
4190 24TH AVE, SUITE:201, FORT GRATIOT, MI 48059-3882
(810) 989-7478
(810) 989-7644

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
4301080585
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1107402142
BLUE CROSS BLUE SHIELD
MI
05
4443518
MI
Enumeration date
09/20/2005
Last updated
07/08/2007
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