Provider Demographics
NPI:1447240072
Name:MITCHELL, SHARON S (MD)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:S
Last Name:MITCHELL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1307 AVON ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4423
Mailing Address - Country:US
Mailing Address - Phone:910-323-1718
Mailing Address - Fax:910-323-3834
Practice Address - Street 1:1307 AVON ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4423
Practice Address - Country:US
Practice Address - Phone:910-323-1718
Practice Address - Fax:910-323-3834
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC33717207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891179MMedicaid
NC1179MOtherBCBS
NC2267531BMedicare Oscar/Certification
NC1179MOtherBCBS