Provider Demographics
NPI:1659575348
Name:SHARP, COLLIN F (MD)
Entity Type:Individual
Prefix:DR
First Name:COLLIN
Middle Name:F
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 1:203 S NEVADA AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-4233
Mailing Address - Country:US
Mailing Address - Phone:970-765-8965
Mailing Address - Fax:970-765-8955
Practice Address - Street 1:203 S NEVADA AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4233
Practice Address - Country:US
Practice Address - Phone:970-765-8965
Practice Address - Fax:970-765-8955
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036167497208600000X
CO47466208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1841420932OtherNPI TYPE 2 - ORGANIZATION
11989498OtherCAQH ID
1659575348OtherNPI TYPE 1 (INDIVIDUAL)
COCO41026OtherMEDICARE INDIVIDUAL PTAN
1841420932OtherNPI TYPE 2 - ORGANIZATION