Provider Demographics
NPI:1194853531
Name:SHARP, CHAD (MD)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:SHARP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 245
Mailing Address - Street 2:1006 CHESTNUT
Mailing Address - City:ASHLAND
Mailing Address - State:KS
Mailing Address - Zip Code:67831-0245
Mailing Address - Country:US
Mailing Address - Phone:316-258-5019
Mailing Address - Fax:316-284-9602
Practice Address - Street 1:301 N MAIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-3444
Practice Address - Country:US
Practice Address - Phone:316-282-9614
Practice Address - Fax:316-284-9602
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2008-07-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-24831207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS04-24831OtherLICENSE