Provider Demographics
NPI:1033482732
Name:WALKER-BEDDINGFIELD, SHAREBAH R (MA)
Entity Type:Individual
Prefix:MRS
First Name:SHAREBAH
Middle Name:R
Last Name:WALKER-BEDDINGFIELD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:SHAREBAH
Other - Middle Name:R
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MEDICAL ASSISTANT
Mailing Address - Street 1:986 EVANGELINE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-3174
Mailing Address - Country:US
Mailing Address - Phone:216-310-4969
Mailing Address - Fax:216-531-3775
Practice Address - Street 1:574 E 200TH ST
Practice Address - Street 2:SUITE 2-3
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-1570
Practice Address - Country:US
Practice Address - Phone:216-310-4969
Practice Address - Fax:216-531-3775
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-12
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy