Provider Demographics
NPI:1932117470
Name:SHARP, DAVID G (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:G
Last Name:SHARP
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18011 OAK ST UNIT 18011A
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-6057
Mailing Address - Country:US
Mailing Address - Phone:402-502-9454
Mailing Address - Fax:402-505-8209
Practice Address - Street 1:18011 OAK ST UNIT 18011A
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-6057
Practice Address - Country:US
Practice Address - Phone:402-502-9454
Practice Address - Fax:402-505-8209
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE144207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE31565OtherBLUE CROSS BLUE SHIELD
NE30696OtherBLUE CROSS BLUE SHIELD
NEP00379255OtherMEDICARE RAILROAD
NE0402690OtherUHC SHARE ADVANTAGE
NE10025485600Medicaid
NEP00332774OtherMEDICARE RAILROAD D4S
NE0402527OtherUHC SHARE ADVANTAGE
NE12291OtherMIDLANDS CHOICE
280290Medicare PIN
NEP00379255OtherMEDICARE RAILROAD
NEF74502Medicare UPIN