MEDICARE: SHARON LYNN MONTGOMERY PA

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	363AM0700X	Medical Physician Assistant	MA000920L	PA

General Provider Information

NPI Number	:	1952300626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON LYNN MONTGOMERY PA

Provider Business Mailing Address
First Line	:	1601 MOTOR INN DR
Second Line	:	SUITE 240
City	:	GIRARD
State	:	OH
Zip	:	44420-2420
Country	:	US
Telephone Number	:	330-759-6750
Fax Number	:	330-759-6755

Provider Business Practice Location Address
First Line	:	1384 OLD FREEPORT RD
Second Line	:	1A
City	:	PITTSBURGH
State	:	PA
Zip	:	15238-3129
Country	:	US
Telephone Number	:	412-967-9220
Fax Number	:	412-967-9303

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	03/27/2024

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Directions to “ SHARON LYNN MONTGOMERY PA” Practice Location

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