Provider Demographics
NPI:1245389014
Name:RINGGOLD, SHARON DENISE (DPM)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:DENISE
Last Name:RINGGOLD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:#124
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3930
Mailing Address - Country:US
Mailing Address - Phone:410-281-9463
Mailing Address - Fax:
Practice Address - Street 1:6400 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:#124
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-3930
Practice Address - Country:US
Practice Address - Phone:410-281-9463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01282213EP1101X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD603301600Medicaid
MD3857150001Medicare NSC
MDU75240Medicare UPIN
MD603301600Medicaid