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NPI Code Detail

MEDICARE: SHARON ANNETTE SMITH PA-C

MEDICARE: SHARON ANNETTE SMITH PA-C
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
1363A00000XPhysician Assistant103786NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518954460
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARON ANNETTE SMITH PA-C
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number : 704-384-7840
Fax Number : 704-384-7830
Provider Business Practice Location Address
First Line : 885 SUMMIT CROSSING PL
Second Line :
City : GASTONIA
State : NC
Zip : 28054-2193
Country : US
Telephone Number : 704-316-4979
Fax Number : 704-316-4978
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2005
Last Update Date : 01/03/2024

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Directions to “ SHARON ANNETTE SMITH PA-C” Practice Location

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