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General NPI Number Information
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NPI Number | 1811202534
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Entity Type | Individual
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Provider Name | SHARON ALSTON PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 08/18/2010
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Last Update Date | 08/18/2010
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Provider Practice Location Address
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Address Line | 1580 BOGGS RD 700
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City | DULUTH
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State | GA
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Zip | 30096-1229
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Country | US
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Telephone | 678-531-4911
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Fax |
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Provider Business Mailing Address
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Address Line | 4320 HORDER CT
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City | SNELLVILLE
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State | GA
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Zip | 30039-8658
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Country | US
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Telephone | 770-978-1338
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 002667
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License Number State | GA
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