Provider Demographics
NPI:1942292461
Name:GEORGE, SHARON L (DO)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:L
Last Name:GEORGE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 SOUTHERN BLVD NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44485-2537
Mailing Address - Country:US
Mailing Address - Phone:330-898-4300
Mailing Address - Fax:330-898-5828
Practice Address - Street 1:420 SOUTHERN BLVD NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485-2537
Practice Address - Country:US
Practice Address - Phone:330-898-4300
Practice Address - Fax:330-898-5828
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2008-07-08
Deactivation Date:2006-03-25
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
OH34005112207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000129115OtherUNISON MEDICAID HMO
OH0849989Medicaid
PA1009042440001OtherMEDICAID
OH341819293027OtherCARESOURCE MEDICAID HMO
OH34181929310243OtherAETNA
OHP006767OtherGATEWAY MEDICAID HMO
OH010044662OtherRAILROD MEDICARE
OH3418192932644OtherAETNA PPO
OHQ019005OtherTHE HEALTH PLAN
OH000000139737OtherANTHEM INDIVIDUAL
OHQ019005OtherTHE HEALTH PLAN
OH0849989Medicaid