Provider Demographics
NPI:1922784123
Name:SANDERS, SHARON (MS RDN LD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MS RDN LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2528 OSTLIN ST
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-5926
Mailing Address - Country:US
Mailing Address - Phone:205-475-4544
Mailing Address - Fax:
Practice Address - Street 1:401 TUSCALOOSA AVE SW STE 100
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1424
Practice Address - Country:US
Practice Address - Phone:938-222-6721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5125133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered