Provider Demographics
NPI:1164422853
Name:SHARP, DALE STEVEN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DALE
Middle Name:STEVEN
Last Name:SHARP
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2817 ROCK MERRITT AVENUE
Mailing Address - Street 2:
Mailing Address - City:FT LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:28390
Mailing Address - Country:US
Mailing Address - Phone:910-643-9483
Mailing Address - Fax:910-907-8631
Practice Address - Street 1:1061 HARMON AVE
Practice Address - Street 2:SUITE 1D03
Practice Address - City:FT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314-5604
Practice Address - Country:US
Practice Address - Phone:912-435-5648
Practice Address - Fax:912-435-5646
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA-003129-L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical