| NPI | 1497732101 |
|---|---|
| Doing Business As | SHARON SURGICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | EVAN PAUL PROVISOR President 860-364-0226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2007-08-10 |