Provider Demographics
NPI:1700318920
Name:CHAMBERS, SHARDE FONTAINE (DO)
Entity type:Individual
Prefix:
First Name:SHARDE
Middle Name:FONTAINE
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CHEWS LANDING RD APT 817
Mailing Address - Street 2:
Mailing Address - City:LINDENWOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-6728
Mailing Address - Country:US
Mailing Address - Phone:954-638-4517
Mailing Address - Fax:
Practice Address - Street 1:1468 MONTREAL RD
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-6901
Practice Address - Country:US
Practice Address - Phone:770-638-1400
Practice Address - Fax:770-638-1411
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA92798207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine