Provider Demographics
NPI:1467494500
Name:SPEED, SHARON Y (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:Y
Last Name:SPEED
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 1:231 N JUDD PKWY NE
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-2694
Mailing Address - Country:US
Mailing Address - Phone:919-235-6560
Mailing Address - Fax:919-235-6597
Practice Address - Street 1:231 N JUDD PKWY NE
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2694
Practice Address - Country:US
Practice Address - Phone:919-235-6560
Practice Address - Fax:919-235-6597
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23081207Q00000X
NC201402479207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALE21647Medicare UPIN
AL051526566Medicare ID - Type Unspecified