Provider Demographics
NPI:1962505081
Name:SHARP, STANLEY PERRY (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:PERRY
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 1:5209 W 68 ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208
Mailing Address - Country:US
Mailing Address - Phone:913-432-5947
Mailing Address - Fax:816-777-8888
Practice Address - Street 1:1310 CARONDELET DR
Practice Address - Street 2:STE 230
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4800
Practice Address - Country:US
Practice Address - Phone:816-777-8888
Practice Address - Fax:816-777-1777
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6B11207R00000X
KS0420798207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO742870072OtherMOST INSURANCE
MO12912117OtherBLUE CROSS
MOC50796Medicare UPIN
0006614Medicare ID - Type Unspecified