Provider Demographics
NPI:1508956558
Name:SHARPE, SHEL (MD)
Entity Type:Individual
Prefix:
First Name:SHEL
Middle Name:
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 1:39 SHOALS FERRY RD SE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-9199
Mailing Address - Country:US
Mailing Address - Phone:706-291-0562
Mailing Address - Fax:706-233-9094
Practice Address - Street 1:39 SHOALS FERRY RD SE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-9199
Practice Address - Country:US
Practice Address - Phone:706-291-0562
Practice Address - Fax:706-233-9094
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0201512084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000633355BMedicaid
GA000633355BMedicaid
GA86BBBBFMedicare ID - Type Unspecified