Provider Demographics
NPI:1801233697
Name:ZWICK-HAMILTON, SHARON (MS,RDN,CDE,CSG,LD)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:ZWICK-HAMILTON
Suffix:
Gender:F
Credentials:MS,RDN,CDE,CSG,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VILLA BEACH CLUB, COTT 14
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-1265
Mailing Address - Country:US
Mailing Address - Phone:216-738-0047
Mailing Address - Fax:
Practice Address - Street 1:15445 LAKE SHORE BLVD
Practice Address - Street 2:VILLA BEACH CLUB, COTT 14
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-1265
Practice Address - Country:US
Practice Address - Phone:216-738-0047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2840133V00000X, 133VN1005X, 133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic