Butheinah A Al-Sharafi, MD
Individual provider Active NPI Endocrinology, Diabetes & Metabolism Physician · Fort Gratiot, MI
NPI 1922094556 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1922094556
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician 207RE0101X
- License
- 4301080585 (MI)
- Practice address
- 4190 24TH Ave
Suite:201
Fort Gratiot, MI 48059-3882 - Phone
- (810) 989-7478
- Fax
- (810) 989-7644
- NPI assigned
- Sep 20, 2005
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301080585 | MI | MD | Endocrinology, Diabetes & Metabolism Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 4301080585 | MI | Yes |
Addresses
Primary practice location
4190 24TH Ave
Suite:201
Fort Gratiot, MI 48059-3882
Mailing address
4190 24TH Ave
Suite:201
Fort Gratiot, MI 48059-3882
Phone (810) 989-7478
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1107402142 | Other | MI | BLUE CROSS BLUE SHIELD |
| 4443518 | Medicaid | MI |
Other providers in Fort Gratiot, MI
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- Carley Louise Agostino
- Kelly Aiello
- Aiso PLLC
- Ahmad Alabbas
- Alexandra Alandt
- Korryn Irene Albert
- Alcott Blue Water Chiropractic, Inc.
- Scott Douglas Alcott
All providers in Fort Gratiot, MI · Endocrinology, Diabetes & Metabolism Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.