Individual
SHARON LINDA PETITJEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4107 W MERCURY BLVD, HAMPTON, VA 23666-3729
(757) 251-7977
(757) 251-7981
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101044063
VA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
0101044063
VA
Other
Enumeration date
12/22/2005
Last updated
02/15/2014
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