MEDICARE: MS. SHARON KAYE UPTON R.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	133V00000X	Registered Dietitian	17379	VA

General Provider Information

NPI Number	:	1871784116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHARON KAYE UPTON R.D.

Provider Business Mailing Address
First Line	:	2807 N PARHAM RD
Second Line	:	SUITE 305
City	:	RICHMOND
State	:	VA
Zip	:	23294-4410
Country	:	US
Telephone Number	:	804-346-9866
Fax Number	:	804-965-0527

Provider Business Practice Location Address
First Line	:	2807 N PARHAM RD
Second Line	:	SUITE 305
City	:	RICHMOND
State	:	VA
Zip	:	23294-4410
Country	:	US
Telephone Number	:	804-346-9866
Fax Number	:	804-965-0527

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

Provider Enumeration Date	:	08/01/2007
Last Update Date	:	08/01/2007

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