=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538959176
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHARIE PIGFORD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2025
-----------------------------------------------------
Last Update Date | 05/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2810 E JOPPA RD
-----------------------------------------------------
City | PARKVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21234-3020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-444-4448
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 222 CASTLETOWN RD
-----------------------------------------------------
City | LUTHERVILLE TIMONIUM
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21093-6715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-493-8140
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | R03520
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------