Provider Demographics
NPI:1528199171
Name:SHARP, SIDNEY E (DPM)
Entity Type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:E
Last Name:SHARP
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1106
Mailing Address - Country:US
Mailing Address - Phone:856-424-8348
Mailing Address - Fax:
Practice Address - Street 1:20 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1106
Practice Address - Country:US
Practice Address - Phone:856-424-8348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00142000213ES0103X
PASC002366L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA417901Medicare ID - Type Unspecified
PAT82272Medicare UPIN