Provider Demographics
NPI:1295086155
Name:REID-GRUNER, SHARI NOLANA (MD)
Entity type:Individual
Prefix:DR
First Name:SHARI
Middle Name:NOLANA
Last Name:REID-GRUNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHARI
Other - Middle Name:NOLANA
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3803 W CHESTER PIKE STE 160
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-2336
Mailing Address - Country:US
Mailing Address - Phone:484-337-1530
Mailing Address - Fax:484-337-1412
Practice Address - Street 1:100 E LANCASTER AVE STE 275
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:845-720-1714
Practice Address - Fax:484-476-1395
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT202150208600000X
MA2710582086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery