Healthcare Provider Details

I. General information

NPI: 1831661065
Provider Name (Legal Business Name): SHARLENE NATASHA HOLMES CPED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2018
Last Update Date: 04/22/2022
Certification Date: 04/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 FRANCIS AVE
BALTIMORE MD
21227-3913
US

IV. Provider business mailing address

733 FREDERICK RD
CATONSVILLE MD
21228-4503
US

V. Phone/Fax

Practice location:
  • Phone: 410-247-3344
  • Fax: 410-247-9110
Mailing address:
  • Phone: 410-719-1222
  • Fax: 410-247-9110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224L00000X
TaxonomyPedorthist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: