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Individual
KENNETH R SHARP
Active
Individual
KENNETH R SHARP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS010664L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000131265
THREE RIVERS/MEDPLUS GRP.
PA
01
—
00000015397
THREE RIVERS/MEDPLUS IND.
PA
05
—
001847462
—
PA
01
—
002653
FIRST PRIORITY INDIV.NUM.
PA
01
—
020286200
FEDERAL BLACK LUNG
PA
01
—
02292600
CAPITAL BLUE SHIELD GROUP
PA
01
—
50036350
CAPITAL BLUE CROSS INDIV.
PA
01
—
CA869935
BLUE SHIELD GROUP NUMBER
PA
01
—
CE2338
RAILROAD MEDICARE GRP.NUM
PA
01
—
P00106254
RAILROAD MEDICARE INDIV.
PA
01
—
P3303851
OXFORD HEALTH PLAN
PA
01
—
SH1300891
BLUE SHIELD IND. ID NUM
PA
Enumeration date
07/21/2005
Last updated
09/24/2018
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