Provider Demographics
NPI:1235409319
Name:SHARP, DAN STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:STEVEN
Last Name:SHARP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 WILLOWDALE RD
Mailing Address - Street 2:MS4020
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2845
Mailing Address - Country:US
Mailing Address - Phone:304-285-6260
Mailing Address - Fax:304-285-6126
Practice Address - Street 1:1095 WILLOWDALE RD
Practice Address - Street 2:MS4020
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2845
Practice Address - Country:US
Practice Address - Phone:304-285-6260
Practice Address - Fax:304-285-6126
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG357362083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine