1770585861 NPI number — DR. SHARON ANN HARIG MD

Table of content: DR. SHARON ANN HARIG MD (NPI 1770585861)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770585861 NPI number — DR. SHARON ANN HARIG MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARIG
Provider First Name:
SHARON
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCULLY
Provider Other First Name:
SHARON
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1770585861
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1293
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEDFORD PARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60499-1293
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
260-969-1950
Provider Business Mailing Address Fax Number:
260-918-2137

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8895 BROADWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERRILLVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46410-7037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-738-2081
Provider Business Practice Location Address Fax Number:
219-650-4311
Provider Enumeration Date:
06/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  01035172A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200076080A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9115389 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 290007864 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000085024 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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