MEDICARE: DR. SHARON PHILLIPS BEALL M.D.

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	2080H0002X	Pediatric Hospice and Palliative Medicine Physician	34097	SC

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

General Provider Information

NPI Number	:	1821086695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARON PHILLIPS BEALL M.D.

Provider Business Mailing Address
First Line	:	136 STONEMARK LN STE 100
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29210-3881
Country	:	US
Telephone Number	:	803-603-4821
Fax Number	:	888-802-6138

Provider Business Practice Location Address
First Line	:	136 STONEMARK LN STE 100
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29210-3881
Country	:	US
Telephone Number	:	803-603-4821
Fax Number	:	888-802-6138

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

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	12/10/2019

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