Provider Demographics
NPI:1053990929
Name:SHOHAM, SIERRA ASHLEY (DO)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:ASHLEY
Last Name:SHOHAM
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:SIERRA
Other - Middle Name:ASHLEY
Other - Last Name:ABDULLAJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2347 TUDOR LN
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-1449
Mailing Address - Country:US
Mailing Address - Phone:727-373-8546
Mailing Address - Fax:
Practice Address - Street 1:4301 W MARKHAM ST # 517
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-603-1508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program