Healthcare Provider Details

I. General information

NPI: 1356331797
Provider Name (Legal Business Name): SHARON HARLEY,MD., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 PEACHTREE ST NW SUITE 450
ATLANTA GA
30309-2519
US

IV. Provider business mailing address

1800 PEACHTREE ST NW SUITE 450
ATLANTA GA
30309-2519
US

V. Phone/Fax

Practice location:
  • Phone: 678-904-5999
  • Fax: 678-904-5998
Mailing address:
  • Phone: 678-904-5999
  • Fax: 678-904-5998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0006X
TaxonomyAmbulatory Fertility Facility
License Number028500
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number028500
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number028500
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number028500
License Number StateGA

VIII. Authorized Official

Name: MISS ROBERT CONLEY
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 678-504-5999