MEDICARE: SHARON L AHART 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	208000000X	Pediatrics Physician	MD00032191	WA

General Provider Information

NPI Number	:	1770697021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON L AHART M.D

Provider Business Mailing Address
First Line	:	815 S AUBURN ST
Second Line	:
City	:	KENNEWICK
State	:	WA
Zip	:	99336-5661
Country	:	US
Telephone Number	:	509-586-5109
Fax Number	:	509-586-5174

Provider Business Practice Location Address
First Line	:	815 S AUBURN ST
Second Line	:
City	:	KENNEWICK
State	:	WA
Zip	:	99336-5661
Country	:	US
Telephone Number	:	509-586-5109
Fax Number	:	509-586-5174

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/08/2007

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