Provider Demographics
NPI:1508862764
Name:SLUBAR DAVIS, SHARON NOEL (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:NOEL
Last Name:SLUBAR DAVIS
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 67000
Mailing Address - Street 2:SUITE 325
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-2728
Mailing Address - Country:US
Mailing Address - Phone:210-615-7700
Mailing Address - Fax:210-615-1782
Practice Address - Street 1:4330 MEDICAL DR
Practice Address - Street 2:SUITE 325
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3342
Practice Address - Country:US
Practice Address - Phone:210-615-7700
Practice Address - Fax:210-615-1782
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2016-11-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA03989363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q19533Medicare UPIN
TX8C0664Medicare PIN