MEDICARE: DR. SHARON ELLEN NEIBEL-PONDEK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080A0000X	Pediatric Adolescent Medicine Physician	D38038	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D38038	OTHER	MD	STATE LICENSE NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	208000000X	OTHER	MD	TAXONOMY NUMBER
4	522272246	OTHER	MD	TAX ID #

General Provider Information

NPI Number	:	1083720445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARON ELLEN NEIBEL-PONDEK M.D.

Provider Business Mailing Address
First Line	:	1138 SPARROW MILL WAY
Second Line	:
City	:	BEL AIR
State	:	MD
Zip	:	21015-6134
Country	:	US
Telephone Number	:	410-838-0343
Fax Number	:

Provider Business Practice Location Address
First Line	:	4C NORTH AVE
Second Line	:	SUITE 403
City	:	BEL AIR
State	:	MD
Zip	:	21014-2330
Country	:	US
Telephone Number	:	410-838-0343
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	07/09/2007

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