Provider Demographics
NPI:1457740508
Name:SHARER, NATHAN ALAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ALAN
Last Name:SHARER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 BRAMBLETON RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4324
Mailing Address - Country:US
Mailing Address - Phone:443-687-9271
Mailing Address - Fax:
Practice Address - Street 1:2412 BRAMBLETON RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-4324
Practice Address - Country:US
Practice Address - Phone:443-687-9271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-13
Last Update Date:2022-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05464103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical