Healthcare Provider Details

I. General information

NPI: 1477055986
Provider Name (Legal Business Name): SHARON RENEE WARE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARON RENEE CANTY

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 N MERIDIAN RD
YOUNGSTOWN OH
44509-1227
US

IV. Provider business mailing address

527 N MERIDIAN RD
YOUNGSTOWN OH
44509-1227
US

V. Phone/Fax

Practice location:
  • Phone: 330-797-0070
  • Fax: 330-797-9146
Mailing address:
  • Phone: 330-797-0070
  • Fax: 330-797-9146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.017246
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number34.017246
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: