Provider Demographics
NPI:1487692349
Name:MIKOL, SHARON J (MD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:J
Last Name:MIKOL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 BELLE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-4202
Mailing Address - Country:US
Mailing Address - Phone:216-529-8446
Mailing Address - Fax:216-529-7048
Practice Address - Street 1:1450 BELLE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4202
Practice Address - Country:US
Practice Address - Phone:216-529-8446
Practice Address - Fax:216-529-7048
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-1399-M207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0633229Medicaid
OH0587741Medicare PIN
OHE76721Medicare UPIN