Healthcare Provider Details
I. General information
NPI: 1437113792
Provider Name (Legal Business Name): SHARON MARIE ALLRED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/13/2006
Last Update Date: 07/22/2020
Certification Date: 07/22/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6285 S HIGLEY RD
GILBERT AZ
85298-4262
US
IV. Provider business mailing address
6285 S HIGLEY RD
GILBERT AZ
85298-4262
US
V. Phone/Fax
- Phone: 480-460-4949
- Fax: 480-460-5858
- Phone: 480-460-4949
- Fax: 480-460-5858
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 34613 |
| License Number State | WI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 30610 |
| License Number State | KY |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 25935 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: