MEDICARE: STANLEY PERRY 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	207R00000X	Internal Medicine Physician	R6B11	MO
2	207R00000X	Internal Medicine Physician	0420798	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	742870072	OTHER	MO	MOST INSURANCE
2	12912117	OTHER	MO	BLUE CROSS

General Provider Information

NPI Number	:	1962505081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STANLEY PERRY SHARP MD

Provider Business Mailing Address
First Line	:	5209 W 68 ST
Second Line	:
City	:	PRAIRIE VILLAGE
State	:	KS
Zip	:	66208
Country	:	US
Telephone Number	:	913-432-5947
Fax Number	:	816-777-8888

Provider Business Practice Location Address
First Line	:	1310 CARONDELET DR
Second Line	:	STE 230
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-4800
Country	:	US
Telephone Number	:	816-777-8888
Fax Number	:	816-777-1777

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

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	12/02/2011

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