Healthcare Provider Details

I. General information

NPI: 1831498344
Provider Name (Legal Business Name): SHARON F. MAIEWSKI P.A.-C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 03/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 W WATER ST
HARRISONBURG VA
22801-3624
US

IV. Provider business mailing address

25 W WATER ST
HARRISONBURG VA
22801-3624
US

V. Phone/Fax

Practice location:
  • Phone: 540-433-5431
  • Fax:
Mailing address:
  • Phone: 540-433-5431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110001455
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: