Provider Demographics
NPI:1659553964
Name:DOAN, SHARON RUTH (MA, CCC-A)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:RUTH
Last Name:DOAN
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:SHARI
Other - Middle Name:RUTH
Other - Last Name:MEIKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-A
Mailing Address - Street 1:1522 PINE GROVE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-3382
Mailing Address - Country:US
Mailing Address - Phone:810-982-3277
Mailing Address - Fax:810-982-0716
Practice Address - Street 1:1522 PINE GROVE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3382
Practice Address - Country:US
Practice Address - Phone:810-982-3277
Practice Address - Fax:810-982-0716
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI16010000394231H00000X
MI3501003082237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI640G411740OtherBCBS HEARING
MI640G411740OtherBCBS HEARING