Provider Demographics
NPI:1952327744
Name:SHARBAUGH, CHRISTOPHER J (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:SHARBAUGH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 RUSTIC LODGE ROAD
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3451
Mailing Address - Country:US
Mailing Address - Phone:724-465-5608
Mailing Address - Fax:724-465-2168
Practice Address - Street 1:272 RUSTIC LODGE ROAD
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3451
Practice Address - Country:US
Practice Address - Phone:724-465-5608
Practice Address - Fax:724-465-2168
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016424680001Medicaid