Provider Demographics
NPI:1467468272
Name:DRAPER, SHARA B (OD)
Entity Type:Individual
Prefix:DR
First Name:SHARA
Middle Name:B
Last Name:DRAPER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SHARA
Other - Middle Name:
Other - Last Name:MAYS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:6121 CEDARCREST RD NW STE 308
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-4205
Practice Address - Country:US
Practice Address - Phone:770-529-7789
Practice Address - Fax:770-529-7791
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1358152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU43731Medicare UPIN
GA41ZCFZXMedicare ID - Type Unspecified