Provider Demographics
NPI:1679075816
Name:HOWARD, SHARON
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3271 OLD JONESBORO RD
Mailing Address - Street 2:
Mailing Address - City:HAPEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30354-1276
Mailing Address - Country:US
Mailing Address - Phone:404-432-1447
Mailing Address - Fax:
Practice Address - Street 1:3271 OLD JONESBORO RD
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1276
Practice Address - Country:US
Practice Address - Phone:404-432-1447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-04
Last Update Date:2018-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA990427681744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management