Provider Demographics
NPI:1033187323
Name:DILLEY, SHARON PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:PATRICIA
Last Name:DILLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28640-9244
Mailing Address - Country:US
Mailing Address - Phone:336-846-7433
Mailing Address - Fax:336-846-7878
Practice Address - Street 1:200 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28640-9244
Practice Address - Country:US
Practice Address - Phone:336-846-7433
Practice Address - Fax:336-846-7878
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76400207R00000X
NC32488207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherONE HEALTH PLAN
4407562OtherAETNA US HEALTHCARE
J12933OtherBLUE SHIELD INDEMNITY
J12933OtherBLUE CARE ELECT
042472266OtherPRIVATE HEALTHCARE SYSTEM
MA3105881Medicaid
917653OtherFIRST HEALTH
9900883OtherFALLON COMMUNITY HEALTH P
9097625OtherCIGNA HEALTH PLAN
3105881OtherWELFARE MEDICAID
AA1199OtherHARVARD PILGRIM HEALTHCAR
J12933OtherBLUE SHIELD HMO BLUE
C87444Medicare UPIN
J12933OtherBLUE CARE ELECT
MAJ12933Medicare ID - Type Unspecified
J12933Medicare ID - Type UnspecifiedB
MA3105881Medicaid
4407562OtherAETNA US HEALTHCARE
784250OtherMVP HEALTH CARE
9097625OtherCIGNA HEALTH PLAN