Healthcare Provider Details

I. General information

NPI: 1417758665
Provider Name (Legal Business Name): EMILY M SHARP-SANSOM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 03/24/2025
Certification Date: 03/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

IV. Provider business mailing address

9261 HAWKSRIDGE DR
COVINGTON KY
41017-9136
US

V. Phone/Fax

Practice location:
  • Phone: 513-862-2563
  • Fax: 513-751-8638
Mailing address:
  • Phone: 606-547-7442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: