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General NPI Number Information
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NPI Number | 1164421723
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Entity Type | Individual
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Provider Name | IRA ROBERT SHARP M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2005
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Last Update Date | 08/24/2011
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Provider Practice Location Address
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Address Line | 201 OLD YORK RD SUITE 205
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City | JENKINTOWN
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State | PA
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Zip | 19046-3200
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Country | US
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Telephone | 215-885-6767
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Fax | 215-885-5297
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Provider Business Mailing Address
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Address Line | 705 BOBWHITE LN
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006-2119
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Country | US
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Telephone | 215-885-6767
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Fax | 215-885-5297
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | MD024070E
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License Number State | PA
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