Healthcare Provider Details

I. General information

NPI: 1003921388
Provider Name (Legal Business Name): ANNE H. SHOLES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 K ST STE 410 NEUROSURGERY
SACRAMENTO CA
95816-5119
US

IV. Provider business mailing address

2801 K ST SUITE 410
SACRAMENTO CA
95816-5120
US

V. Phone/Fax

Practice location:
  • Phone: 916-733-8277
  • Fax:
Mailing address:
  • Phone: 916-733-8277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number020405
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberC52546
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: