Healthcare Provider Details

I. General information

NPI: 1629095310
Provider Name (Legal Business Name): SHARON K ESKAM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 HOUSE AVE SUITE 400
CHEYENNE WY
82001-3176
US

IV. Provider business mailing address

2301 HOUSE AVE SUITE 400
CHEYENNE WY
82001-3176
US

V. Phone/Fax

Practice location:
  • Phone: 307-634-5216
  • Fax: 307-638-6675
Mailing address:
  • Phone: 307-634-5216
  • Fax: 307-638-6675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD61388529
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4077A
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: