Provider Demographics
NPI:1164955118
Name:SHARPE, MARIE SUZANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:SUZANNE
Last Name:SHARPE
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 1:500 SUPERIOR AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3609
Mailing Address - Country:US
Mailing Address - Phone:949-644-2722
Mailing Address - Fax:343-650-3135
Practice Address - Street 1:500 SUPERIOR AVE STE 310
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3609
Practice Address - Country:US
Practice Address - Phone:949-644-2722
Practice Address - Fax:949-650-3135
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-06
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA158131207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program