Provider Demographics
NPI:1548400880
Name:HALTER, SHARON (CCP)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:HALTER
Suffix:
Gender:F
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 LINCOLN PARK BLVD
Mailing Address - Street 2:SUITE 322
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-3474
Mailing Address - Country:US
Mailing Address - Phone:937-297-6800
Mailing Address - Fax:937-297-6810
Practice Address - Street 1:580 LINCOLN PARK BLVD
Practice Address - Street 2:SUITE 322
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-3474
Practice Address - Country:US
Practice Address - Phone:937-297-6800
Practice Address - Fax:937-297-6810
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist