Provider Demographics
NPI:1851360101
Name:ELVEY, SHARON M (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:M
Last Name:ELVEY
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 1:2129 W OREGON AVE
Mailing Address - Street 2:FIRST FLOOR REAR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-4131
Mailing Address - Country:US
Mailing Address - Phone:215-462-6106
Mailing Address - Fax:215-462-5922
Practice Address - Street 1:2129 W OREGON AVE
Practice Address - Street 2:FIRST FLOOR REAR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-4131
Practice Address - Country:US
Practice Address - Phone:215-462-6106
Practice Address - Fax:215-462-5922
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024858E2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000802232001Medicaid
PAB37061Medicare UPIN