Provider Demographics
NPI:1982671228
Name:ROBERTS, SHARON (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:ROBERTS
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 1:118 MUIRFIELD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23430-6994
Mailing Address - Country:US
Mailing Address - Phone:678-982-7779
Mailing Address - Fax:
Practice Address - Street 1:118 MUIRFIELD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:VA
Practice Address - Zip Code:23430-6994
Practice Address - Country:US
Practice Address - Phone:678-982-7779
Practice Address - Fax:678-982-7779
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031189207P00000X, 207R00000X
VA0101246273207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000473448OMedicaid
VA1982671228Medicaid
GA000473448OMedicaid
VA1982671228Medicaid