Provider Demographics
NPI:1780220863
Name:MASTER, SHARON (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:MASTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3816 PIERMONT DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3416
Mailing Address - Country:US
Mailing Address - Phone:505-235-0983
Mailing Address - Fax:
Practice Address - Street 1:1930 EDWARDS LAKE RD STE 138
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3720
Practice Address - Country:US
Practice Address - Phone:205-308-3183
Practice Address - Fax:205-278-6937
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-23
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL01D2144684291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory