Provider Demographics
NPI:1164421723
Name:SHARP, IRA ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:IRA
Middle Name:ROBERT
Last Name:SHARP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:705 BOBWHITE LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-2119
Mailing Address - Country:US
Mailing Address - Phone:215-885-6767
Mailing Address - Fax:215-885-5297
Practice Address - Street 1:201 OLD YORK RD
Practice Address - Street 2:SUITE 205
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3200
Practice Address - Country:US
Practice Address - Phone:215-885-6767
Practice Address - Fax:215-885-5297
Is Sole Proprietor?:No
Enumeration Date:2005-07-17
Last Update Date:2011-08-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD024070E207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB30258Medicare UPIN