Provider Demographics
NPI:1760588479
Name:SHARON F MILLER DO PC
Entity Type:Organization
Organization Name:SHARON F MILLER DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-981-8883
Mailing Address - Street 1:752 BROOKSHIRE DR STE E
Mailing Address - Street 2:PO BOX 1435
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-4510
Mailing Address - Country:US
Mailing Address - Phone:724-981-8883
Mailing Address - Fax:724-981-7260
Practice Address - Street 1:752 BROOKSHIRE DR
Practice Address - Street 2:SUITE E
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-4510
Practice Address - Country:US
Practice Address - Phone:724-981-8883
Practice Address - Fax:724-981-7260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 006287 L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0126825Medicaid
F15062Medicare UPIN
PAF15062Medicare UPIN
PA063509Medicare ID - Type Unspecified