Healthcare Provider Details

I. General information

NPI: 1053373803
Provider Name (Legal Business Name): SHARON R ATKIN M.S.A., O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OPTOMETRY CLINIC VAMC
PERRY POINT MD
21902
US

IV. Provider business mailing address

94 HUNT VALLEY LOOP
ELKTON MD
21921-1940
US

V. Phone/Fax

Practice location:
  • Phone: 410-642-2411
  • Fax:
Mailing address:
  • Phone: 410-642-2411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18002204
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOE-6379-P
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: