Doctor Name: | SHARON ELTZ |
NPI Number: | 1205057965 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | MT188114 |
Business Practice Address: | 5665 Main Street East Petersburg, PA - 175201513 |
Business Phone Number: | 7175697011 |
Business Fax Number: | 7175698694 |
Mailing Address: | 5665 Main Street, EAST PETERSBURG |
State: | PA |
Postal Code: | 175201513 |
Phone Number: | 7175697011 |
Fax Number: | 7175698694 |
NPI Enumeration Date: | 05/01/2007 |
NPI Last Update Date: | 06/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | MT188114 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |