Provider Demographics
NPI:1053516468
Name:MOLINE, S. SHARON (PT)
Entity type:Individual
Prefix:MRS
First Name:S.
Middle Name:SHARON
Last Name:MOLINE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:SAGHI
Other - Middle Name:SHARON
Other - Last Name:SADEGHIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:13030 FOREST DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4344
Mailing Address - Country:US
Mailing Address - Phone:301-675-3760
Mailing Address - Fax:240-766-0568
Practice Address - Street 1:810 BESTGATE RD STE 220
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3648
Practice Address - Country:US
Practice Address - Phone:855-527-7246
Practice Address - Fax:866-229-5063
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-16
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist