Provider Demographics
NPI:1689748493
Name:SHARP, RODNEY D (RPH)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:D
Last Name:SHARP
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21811 KELLY ROAD, SUITE 103
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-2793
Mailing Address - Country:US
Mailing Address - Phone:810-919-8635
Mailing Address - Fax:586-745-7273
Practice Address - Street 1:21811 KELLY ROAD, SUITE 103
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-2793
Practice Address - Country:US
Practice Address - Phone:810-919-8635
Practice Address - Fax:586-745-7273
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020251631835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric