MEDICARE: BRIAN SHARKEY CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	R137750	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8301302	OTHER		EVERCARE
3	0943ER-618712-03	OTHER		CAREFIRST BCBS OF MD
4	61871201	OTHER	MD	BCBS
5	138CER618172-01	OTHER		CAREFIRST BCBS OF MD
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	T016-0033	OTHER		BCBS-DC

General Provider Information

NPI Number	:	1548235336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN SHARKEY CRNP

Provider Business Mailing Address
First Line	:	701 MAIDEN CHOICE LN
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21228-5968
Country	:	US
Telephone Number	:	410-737-8838
Fax Number	:	410-314-7979

Provider Business Practice Location Address
First Line	:	711 MAIDEN CHOICE LN
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21228-3632
Country	:	US
Telephone Number	:	410-247-5602
Fax Number	:	410-247-1756

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	07/17/2009

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Directions to “ BRIAN SHARKEY CRNP” Practice Location

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