Provider Demographics
NPI:1225035983
Name:ADHAMI, SHARON S (OD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:S
Last Name:ADHAMI
Suffix:
Gender:F
Credentials:OD
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 1471
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-1471
Mailing Address - Country:US
Mailing Address - Phone:615-554-2842
Mailing Address - Fax:
Practice Address - Street 1:5020 SPEDALE CT
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-6105
Practice Address - Country:US
Practice Address - Phone:615-302-3211
Practice Address - Fax:615-302-3278
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD-T2580152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3946718Medicaid
TN11542472OtherCAQH ID
TN4238385OtherBLUE CROSS BLUE SHIELD
TN4329289OtherCIGNA
TNTN9270OtherUNITED HEALTH CARE
TN4238385OtherBLUE CROSS BLUE SHIELD
TN11542472OtherCAQH ID