Basic Information
Provider Information | |||||||||
NPI: | 1396975868 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | EL SHERIF | ||||||||
FirstName: | AMIRA | ||||||||
MiddleName: | A | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1500 GALEN ST SE | ||||||||
Address2: |   | ||||||||
City: | WASHINGTON | ||||||||
State: | DC | ||||||||
PostalCode: | 200204913 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2024694699 | ||||||||
FaxNumber: | 2025488600 | ||||||||
Practice Location | |||||||||
Address1: | 1500 GALEN ST SE | ||||||||
Address2: |   | ||||||||
City: | WASHINGTON | ||||||||
State: | DC | ||||||||
PostalCode: | 200204913 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2024694699 | ||||||||
FaxNumber: | 2025488600 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/20/2009 | ||||||||
LastUpdateDate: | 10/22/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 10/22/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD046546 | DC | Y |   | Allopathic & Osteopathic Physicians | Pediatrics |   |
ID Information
ID | Type | State | Issuer | Description | 1355742 | 01 | NC | WELLPATH | OTHER | 9268862 | 01 | NC | AETNA | OTHER | 1396975868 | 01 | NC | HEALTHNET FEDERAL SERVICES | OTHER | 4015379 | 01 | NC | COVENTRY NATIONAL - COVENTRY PPO | OTHER | FH1101540 | 01 | NC | FIRST CAROLINA CARE | OTHER | 1396975868 | 01 | NC | HUMANA | OTHER | 1396975868 | 01 | NC | DOCTORS DIRECT | OTHER | 6964025 | 01 | NC | CIGNA GREATWEST | OTHER | 1355742 | 01 | NC | COVENTRY OF THE CAROLINAS | OTHER | 1396975868 | 05 | NC |   | MEDICAID | 3500002 | 01 | NC | UNITED HEALTHCARE | OTHER | 1396975868 | 01 | NC | HEALTHSMART | OTHER | 13047524 | 01 | NC | PHCS-MULTIPLAN | OTHER | 242548 | 01 | NC | MEDCOST, LLC | OTHER | 1742P | 01 | NC | BCBS OF NC | OTHER |