Healthcare Provider Details

I. General information

NPI: 1023085669
Provider Name (Legal Business Name): THOMASINA ANDERSON-SHARPE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: THOMASINA ELIZABETH HENKEL MD

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 07/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 MC MEANS AVE. STE C
BAY MINETTE AL
36507
US

IV. Provider business mailing address

108 MCMEANS AVE STE C
BAY MINETTE AL
36507-3130
US

V. Phone/Fax

Practice location:
  • Phone: 251-937-7100
  • Fax: 251-937-9882
Mailing address:
  • Phone: 251-937-7100
  • Fax: 251-937-9882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number18229
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: