Provider Demographics
NPI:1598724551
Name:SHARP, DAVID LEE (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LEE
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 1:101 SMITH DR
Mailing Address - Street 2:#4
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-4129
Mailing Address - Country:US
Mailing Address - Phone:724-776-2333
Mailing Address - Fax:724-776-1972
Practice Address - Street 1:101 SMITH DR
Practice Address - Street 2:#4
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-4129
Practice Address - Country:US
Practice Address - Phone:724-776-2333
Practice Address - Fax:724-776-1972
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024437E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008641460002Medicaid
PA0008641460002Medicaid
PA056858Medicare ID - Type Unspecified