Provider Demographics
NPI:1508197856
Name:BURNS, SHARON MICHELLE (CERTIFIED MEDICAL AS)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:MICHELLE
Last Name:BURNS
Suffix:
Gender:F
Credentials:CERTIFIED MEDICAL AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2377
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29465
Mailing Address - Country:US
Mailing Address - Phone:843-647-3105
Mailing Address - Fax:843-647-3105
Practice Address - Street 1:425 NIAGARA LANE
Practice Address - Street 2:
Practice Address - City:HUGER
Practice Address - State:SC
Practice Address - Zip Code:29450
Practice Address - Country:US
Practice Address - Phone:843-647-3105
Practice Address - Fax:843-647-3105
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor