Provider Demographics
NPI:1467531236
Name:HICKS-GRAHAM, SHARI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARI
Middle Name:
Last Name:HICKS-GRAHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHARI
Other - Middle Name:PHILANA
Other - Last Name:HICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:393 E TOWN ST
Mailing Address - Street 2:SUITE 229
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4741
Mailing Address - Country:US
Mailing Address - Phone:614-224-4566
Mailing Address - Fax:614-224-6046
Practice Address - Street 1:393 E TOWN ST
Practice Address - Street 2:SUITE 229
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4741
Practice Address - Country:US
Practice Address - Phone:614-224-4566
Practice Address - Fax:614-224-6046
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3586908207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology