Provider Demographics
NPI:1699827642
Name:PLETCHER, SHARON L (DPM)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:L
Last Name:PLETCHER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 W COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-2711
Mailing Address - Country:US
Mailing Address - Phone:814-235-5565
Mailing Address - Fax:814-235-1922
Practice Address - Street 1:1318 W COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-2711
Practice Address - Country:US
Practice Address - Phone:814-235-5565
Practice Address - Fax:814-235-1922
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004250L213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU68420Medicare UPIN
PAPL901312Medicare ID - Type Unspecified