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General NPI Number Information
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NPI Number | 1013023340
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Entity Type | Individual
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Provider Name | KENNETH A SHARPE MD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 01/13/2015
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Provider Practice Location Address
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Address Line | 3531 MARY ADER AVE
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City | CHARLESTON
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State | SC
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Zip | 29414-5896
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Country | US
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Telephone | 843-352-0674
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 63350
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City | CHARLOTTE
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State | NC
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Zip | 28263-0001
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Country | US
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Telephone | 843-352-0674
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 10062
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License Number State | SC
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