Provider Demographics
NPI:1659349066
Name:SMITH, SHARON M (MD)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5895
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:99 BEAUVOIR AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3533
Practice Address - Country:US
Practice Address - Phone:908-522-2333
Practice Address - Fax:908-522-4549
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2024-04-29
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06804900207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G80685Medicare UPIN