Healthcare Provider Details

I. General information

NPI: 1417084096
Provider Name (Legal Business Name): SHARON LEE LUDWIG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COMDT (CG-1122), U. S. COAST GUARD 2100 2ND ST SW, SUITE 5314
WASHINGTON DC
20593-0001
US

IV. Provider business mailing address

COMDT (CG-1122), U.S. COAST GUARD 2100 2ND ST SW, SUITE 5314
WASHINGTON DC
20593
US

V. Phone/Fax

Practice location:
  • Phone: 202-475-5185
  • Fax:
Mailing address:
  • Phone: 202-475-5185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberD0054645
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: