MEDICARE: DR. JEROLD M SHARE 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	MD21208	DC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	460002434	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851350508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEROLD M SHARE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1400
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22038-1400
Country	:	US
Telephone Number	:	703-383-9543
Fax Number	:	703-383-9532

Provider Business Practice Location Address
First Line	:	3301 NEW MEXICO AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-3612
Country	:	US
Telephone Number	:	202-244-0060
Fax Number	:	202-362-6907

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

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	12/31/2018

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Directions to “ DR. JEROLD M SHARE M.D.” Practice Location

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