MEDICARE: DR. BRIAN HOWARD SHARP PHD

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	103G00000X	Clinical Neuropsychologist	638	WV
2	103TC0700X	Clinical Psychologist	638	WV

General Provider Information

NPI Number	:	1033162136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN HOWARD SHARP PHD

Provider Business Mailing Address
First Line	:	201 MARKET ST
Second Line	:
City	:	MANNINGTON
State	:	WV
Zip	:	26582-1132
Country	:	US
Telephone Number	:	304-986-1753
Fax Number	:	304-986-1753

Provider Business Practice Location Address
First Line	:	201 MARKET ST
Second Line	:
City	:	MANNINGTON
State	:	WV
Zip	:	26582-1132
Country	:	US
Telephone Number	:	304-986-1753
Fax Number	:	304-986-1753

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	09/11/2025

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