Provider Demographics
NPI:1659484525
Name:JOSEPH, SHARON E (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:E
Last Name:JOSEPH
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 1:3452 ANDERSON HWY
Mailing Address - Street 2:SUITE D
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139-5845
Mailing Address - Country:US
Mailing Address - Phone:804-285-6050
Mailing Address - Fax:804-598-2481
Practice Address - Street 1:3452 ANDERSON HWY
Practice Address - Street 2:SUITE D
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-5845
Practice Address - Country:US
Practice Address - Phone:804-285-6050
Practice Address - Fax:804-598-2481
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215235207R00000X, 208000000X
VA0101241148207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC04469OtherGROUP PTAN
VAC09633OtherGROUP PTAN
VA10022249Medicaid
MAJ29721OtherBC/BS OF MA
MAH89614Medicare UPIN
MAJ29721OtherBC/BS OF MA