Provider Demographics
NPI:1982615613
Name:SHARP, DONOVAN DOUGLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:DONOVAN
Middle Name:DOUGLAS
Last Name:SHARP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7610 E 49TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64129-2043
Mailing Address - Country:US
Mailing Address - Phone:816-560-3828
Mailing Address - Fax:816-921-4995
Practice Address - Street 1:7610 E 49TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64129-2043
Practice Address - Country:US
Practice Address - Phone:816-560-3828
Practice Address - Fax:816-921-4995
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005002603111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor