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NPI Code Detail

MEDICARE: DR. SHARI L COOLBAUGH OD

MEDICARE: DR. SHARI L COOLBAUGH OD
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
1152W00000XOptometrist0601002108VA

General Provider Information

NPI Number : 1649277229
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHARI L COOLBAUGH OD
Provider Business Mailing Address
First Line : 1960 ELECTRIC RD
Second Line :
City : ROANOKE
State : VA
Zip : 24018-1621
Country : US
Telephone Number : 540-772-7171
Fax Number : 540-774-8299
Provider Business Practice Location Address
First Line : 1960 ELECTRIC RD
Second Line :
City : ROANOKE
State : VA
Zip : 24018-1621
Country : US
Telephone Number : 540-772-7171
Fax Number : 540-774-8299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 02/19/2010

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Directions to “ DR. SHARI L COOLBAUGH OD” Practice Location

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