Provider Demographics
NPI:1679607329
Name:SHARKEY, KATHERINE M (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:M
Last Name:SHARKEY
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT 3010,PO BOX 986524
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02298-6524
Mailing Address - Country:US
Mailing Address - Phone:833-924-5546
Mailing Address - Fax:
Practice Address - Street 1:375 WAMPANOAG TRAIL
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915
Practice Address - Country:US
Practice Address - Phone:401-649-4070
Practice Address - Fax:401-649-4071
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD12259207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIKS67888Medicaid