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General NPI Number Information
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NPI Number | 1780220863
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Entity Type | Individual
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Provider Name | SHARON MASTER PHD
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Gender | Female
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Dates
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Enumeration Date | 11/23/2019
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 1930 EDWARDS LAKE RD STE 138
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City | BIRMINGHAM
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State | AL
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Zip | 35235-3720
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Country | US
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Telephone | 205-308-3183
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Fax | 205-278-6937
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Provider Business Mailing Address
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Address Line | 3816 PIERMONT DR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3416
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Country | US
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Telephone | 505-235-0983
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Fax |
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 01D2144684
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License Number State | AL
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