Provider Demographics
NPI:1861067654
Name:YOUNG, SHARDAY TIERRIA (MD)
Entity type:Individual
Prefix:
First Name:SHARDAY
Middle Name:TIERRIA
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 MEDICAL CENTER DR STE 2624
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3656
Mailing Address - Country:US
Mailing Address - Phone:910-337-5022
Mailing Address - Fax:724-324-9005
Practice Address - Street 1:1600 MEDICAL CENTER DR STE 2624
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3656
Practice Address - Country:US
Practice Address - Phone:304-691-1282
Practice Address - Fax:304-691-1287
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program