Provider Demographics
NPI:1902939606
Name:TINANOFF, SHARON (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:TINANOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:TINANOFF
Other - Last Name:LIEBERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:755 MOUNT VERNON HWY NE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:404-252-4100
Mailing Address - Fax:404-252-6740
Practice Address - Street 1:755 MOUNT VERNON HWY NE
Practice Address - Street 2:SUITE 400
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:404-252-4100
Practice Address - Fax:404-252-6740
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA042464207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003126829AMedicaid
F79990Medicare UPIN
GA202I110220Medicare PIN
GA003126829AMedicaid