Provider Demographics
NPI:1447935341
Name:SHARIFMOHAMED, ZAHRA AMIR
Entity type:Individual
Prefix:
First Name:ZAHRA
Middle Name:AMIR
Last Name:SHARIFMOHAMED
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 NORTHWAY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1258
Mailing Address - Country:US
Mailing Address - Phone:320-251-1775
Mailing Address - Fax:
Practice Address - Street 1:1555 NORTHWAY DR STE 100
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1258
Practice Address - Country:US
Practice Address - Phone:320-251-1775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN15294363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant