Provider Demographics
NPI:1639170616
Name:KIELY, SHARON C (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:C
Last Name:KIELY
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 1:320 E NORTH AVE
Mailing Address - Street 2:2ND FL AGH INTERNAL MEDICINE
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3751
Mailing Address - Fax:412-359-8439
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:2ND FL AGH INTERNAL MEDICINE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3751
Practice Address - Fax:412-359-8439
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042492E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011415310006Medicaid
PA0011415310006Medicaid
PA110195620Medicare PIN
PACG2169Medicare PIN
PAE64214Medicare UPIN