MEDICARE: GREGORY SHARP MD PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1114493491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREGORY SHARP MD PLLC

Provider Business Mailing Address
First Line	:	335 MANITOU AVE
Second Line	:
City	:	MANITOU SPRINGS
State	:	CO
Zip	:	80829-2537
Country	:	US
Telephone Number	:	719-686-8844
Fax Number	:	719-686-7449

Provider Business Practice Location Address
First Line	:	335 MANITOU AVE
Second Line	:
City	:	MANITOU SPRINGS
State	:	CO
Zip	:	80829-2537
Country	:	US
Telephone Number	:	719-686-8844
Fax Number	:	719-686-7449

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GREGORY EVAN SHARP
Credential	:	MD
Telephone Number	:	719-686-8844

Provider Enumeration Date	:	10/15/2018
Last Update Date	:	10/15/2018

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