Basic Information
Provider Information
NPI: 1750490504
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LYNCH-MILLER
FirstName: SHARON
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1279 HIGHWAY 54 WEST
Address2: SUITE 220
City: FAYETTEVILLE
State: GA
PostalCode: 302144552
CountryCode: US
TelephoneNumber: 7709912200
FaxNumber: 7709911341
Practice Location
Address1: 1279 HIGHWAY 54 W
Address2: SUITE 220
City: FAYETTEVILLE
State: GA
PostalCode: 302144552
CountryCode: US
TelephoneNumber: 7709912200
FaxNumber: 7709911341
Other Information
ProviderEnumerationDate: 08/29/2006
LastUpdateDate: 10/22/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X042342GAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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