Individual
SHARDE NEWSOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PBT
Contact information
Practice address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 754-2078
Mailing address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 754-2078
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
58575
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442192
—
OH
Enumeration date
05/10/2021
Last updated
06/06/2021
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