Provider Demographics
NPI:1780841957
Name:MBUKO, SHARON A (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:A
Last Name:MBUKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:A
Other - Last Name:MUKOOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6455
Mailing Address - Country:US
Mailing Address - Phone:256-429-5196
Mailing Address - Fax:256-429-4573
Practice Address - Street 1:1 HOSPITAL DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6455
Practice Address - Country:US
Practice Address - Phone:256-429-5196
Practice Address - Fax:256-429-4573
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL31183207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPENDINGMedicaid
LA06239Medicaid
LA06239Medicaid