Provider Demographics
NPI:1710960216
Name:LOJUN, SHARON LEE (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LEE
Last Name:LOJUN
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:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2487
Mailing Address - Country:US
Mailing Address - Phone:920-445-7222
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:1545 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504
Practice Address - Country:US
Practice Address - Phone:850-416-7101
Practice Address - Fax:850-416-7103
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2019-02-13
Deactivation Date:2009-02-09
Deactivation Code:
Reactivation Date:2011-06-03
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05427100207VX0201X
NY221670-1207VX0201X
MA238217207VX0201X
WI18337-875207VX0201X
FLME135319207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02176025Medicaid
NY469D11Medicare ID - Type Unspecified
NY02176025Medicaid