Provider Demographics
NPI:1942419411
Name:ABOUTANOS, SHARLINE Z (MD)
Entity Type:Individual
Prefix:
First Name:SHARLINE
Middle Name:Z
Last Name:ABOUTANOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5899 BREMO RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1935
Mailing Address - Country:US
Mailing Address - Phone:804-285-4115
Mailing Address - Fax:804-673-6714
Practice Address - Street 1:5899 BREMO RD
Practice Address - Street 2:SUITE 205
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1935
Practice Address - Country:US
Practice Address - Phone:804-285-4115
Practice Address - Fax:804-673-6714
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA1942419411208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery