Provider Demographics
NPI:1962529768
Name:MAGILL, SHARON LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LYNN
Last Name:MAGILL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:444 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-3218
Mailing Address - Country:US
Mailing Address - Phone:443-203-6951
Mailing Address - Fax:
Practice Address - Street 1:2331 FOREST DR STE A
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3868
Practice Address - Country:US
Practice Address - Phone:410-224-8908
Practice Address - Fax:410-224-0871
Is Sole Proprietor?:No
Enumeration Date:2007-03-25
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1587152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD172569ZFXQMedicare PIN
MD491391Medicare UPIN