Provider Demographics
NPI:1821262890
Name:SHARPE, JOHN PARKER (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PARKER
Last Name:SHARPE
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 1:5415 CARDINAL SQUARE BLVD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-8200
Mailing Address - Country:US
Mailing Address - Phone:989-583-5679
Mailing Address - Fax:
Practice Address - Street 1:5415 CARDINAL SQUARE BLVD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604
Practice Address - Country:US
Practice Address - Phone:989-790-4855
Practice Address - Fax:989-790-7335
Is Sole Proprietor?:No
Enumeration Date:2008-04-21
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN528652086S0102X
390200000X
MI43011192502086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program