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General NPI Number Information
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NPI Number | 1114493491
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Entity Type | Organization
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Legal Business Name | GREGORY SHARP MD PLLC
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Dates
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Enumeration Date | 10/15/2018
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Last Update Date | 10/15/2018
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Provider Practice Location Address
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Address Line | 335 MANITOU AVE
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City | MANITOU SPRINGS
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State | CO
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Zip | 80829-2537
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Country | US
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Telephone | 719-686-8844
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Fax | 719-686-7449
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Provider Business Mailing Address
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Address Line | 335 MANITOU AVE
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City | MANITOU SPRINGS
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State | CO
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Zip | 80829-2537
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Country | US
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Telephone | 719-686-8844
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Fax | 719-686-7449
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY EVAN SHARP
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Credential | MD
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Telephone | 719-686-8844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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