MEDICARE: SCOTT M SHARP MD

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	207RC0000X	Cardiovascular Disease Physician	01035254A	IN
2	207RI0011X	Interventional Cardiology Physician	01035254A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01214690	OTHER	IN	RR MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	4226155	OTHER	IN	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518966712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT M SHARP MD

Provider Business Mailing Address
First Line	:	6626 E 75TH ST
Second Line	:	SUITE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8075 N SHADELAND AVE
Second Line	:	SUITE 200
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2693
Country	:	US
Telephone Number	:	317-621-8500
Fax Number	:	317-621-8501

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	06/14/2021

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Directions to “ SCOTT M SHARP MD” Practice Location

Language	Start Address	Practice Location

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