Individual
DR. SHARON BUCKWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 MOYE BLVD, ECU PHYSICIANS PEDIATRIC OUTPATIENT CENTER, GREENVILLE, NC 27834-4300
(252) 744-2335
(252) 744-2811
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
(252) 744-3520
(252) 744-3194
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
200300213
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13305
BCBS NC
NC
05
—
8913305
—
NC
01
—
P00012998
RAILROAD MEDICARE
NC
Enumeration date
07/01/2005
Last updated
11/01/2011
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