Provider Demographics
NPI:1811163595
Name:WALTER, SHARONE A (PA-C)
Entity type:Individual
Prefix:MS
First Name:SHARONE
Middle Name:A
Last Name:WALTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 W PRAIRIE ST
Mailing Address - Street 2:
Mailing Address - City:HARRISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16038-1729
Mailing Address - Country:US
Mailing Address - Phone:724-735-2806
Mailing Address - Fax:
Practice Address - Street 1:7180 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-1206
Practice Address - Country:US
Practice Address - Phone:412-365-4924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001768L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical