Provider Demographics
NPI:1659367803
Name:MCDONALD, SHARON GAIL (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:GAIL
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3844 S LINDBERGH BLVD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:SUNSET HILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1368
Mailing Address - Country:US
Mailing Address - Phone:314-842-6630
Mailing Address - Fax:314-842-7543
Practice Address - Street 1:3844 S LINDBERGH BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:SUNSET HILLS
Practice Address - State:MO
Practice Address - Zip Code:63127-1368
Practice Address - Country:US
Practice Address - Phone:314-842-6630
Practice Address - Fax:314-842-7543
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR7853207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205018815Medicaid
MO205018815Medicaid
MOC02448Medicare UPIN