Provider Demographics
NPI:1780617654
Name:SORENSEN, SHARON (AUD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19110 MONTGOMERY VILLAGE AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20886-3702
Mailing Address - Country:US
Mailing Address - Phone:301-977-6317
Mailing Address - Fax:301-977-8504
Practice Address - Street 1:19110 MONTGOMERY VILLAGE AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20886-3702
Practice Address - Country:US
Practice Address - Phone:301-977-6317
Practice Address - Fax:301-977-8504
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00392231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLO98SW-53066003OtherCAREFIRST MD OFFICE #2
MD9419833OtherPHCS
MD8608484-001OtherCIGNA
MD801591-034954OtherJOHN HOPKINS HEALTH CARE
MD5309254OtherAETNA PPO
MHLO98SW-53066001OtherCAREFIRST MD OFFICE #1
MD221808OtherUNITED HEALTHCARE
MD1320-0001OtherCAREFIRST FEDERAL EMPLOYE
MD3460132OtherAETNA HMO
MD8608484-001OtherCIGNA