Healthcare Provider Details

I. General information

NPI: 1811163595
Provider Name (Legal Business Name): SHARONE A WALTER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7180 HIGHLAND DR
PITTSBURGH PA
15206-1206
US

IV. Provider business mailing address

535 W PRAIRIE ST
HARRISVILLE PA
16038-1729
US

V. Phone/Fax

Practice location:
  • Phone: 412-365-4924
  • Fax:
Mailing address:
  • Phone: 724-735-2806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA001768L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: