Provider Demographics
NPI:1063395432
Name:SHARIF, ABDULRAHMAN
Entity type:Individual
Prefix:
First Name:ABDULRAHMAN
Middle Name:
Last Name:SHARIF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 LYNDALE AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420-2238
Mailing Address - Country:US
Mailing Address - Phone:612-501-7514
Mailing Address - Fax:
Practice Address - Street 1:4640 SLATER RD
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-4043
Practice Address - Country:US
Practice Address - Phone:612-478-1341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities