Healthcare Provider Details

I. General information

NPI: 1710960216
Provider Name (Legal Business Name): SHARON LEE LOJUN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 02/13/2019
Certification Date:
Deactivation Date: 02/09/2009
Reactivation Date: 06/03/2011

III. Provider practice location address

1545 AIRPORT BLVD
PENSACOLA FL
32504
US

IV. Provider business mailing address

PO BOX 22487
GREEN BAY WI
54305-2487
US

V. Phone/Fax

Practice location:
  • Phone: 850-416-7101
  • Fax: 850-416-7103
Mailing address:
  • Phone: 920-445-7222
  • Fax: 920-445-7289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number25MA05427100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number221670-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number238217
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number18337-875
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberME135319
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: