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General NPI Number Information
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NPI Number | 1326277013
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Entity Type | Individual
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Provider Name | CRYSTAL SHARON M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/02/2009
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 1001 S KNIK GOOSE BAY RD
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City | WASILLA
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State | AK
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Zip | 99654-8083
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Country | US
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Telephone | 907-631-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 7033 E TUDOR RD STE Q
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City | ANCHORAGE
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State | AK
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Zip | 99507-1262
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Country | US
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Telephone | 907-729-8901
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Fax | 907-729-5180
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 067701
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 133093
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License Number State | AK
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