Provider Demographics
NPI:1083702849
Name:CHANEY, SHARON BROM (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:BROM
Last Name:CHANEY
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:PO BOX 430125
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-1125
Mailing Address - Country:US
Mailing Address - Phone:205-595-0395
Mailing Address - Fax:205-599-9024
Practice Address - Street 1:2008 STONEGATE TRL 100
Practice Address - Street 2:
Practice Address - City:VESTAVIA HLS
Practice Address - State:AL
Practice Address - Zip Code:35242-2267
Practice Address - Country:US
Practice Address - Phone:205-595-0395
Practice Address - Fax:205-599-9024
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00023549207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-91791OtherAL BCBS
ALH61233OtherVIVA
AL7086371OtherAETNA
ALH61233OtherHEALTHSPRING
ALP00192328OtherMEDICARE RAILROAD
ALH61233Medicare UPIN