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Individual
MR. RYAN D SHARP
Active
Individual
MR. RYAN D SHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0003403
CO
363AM0700X
Medical Physician Assistant
1004
NE
363AS0400X
Surgical Physician Assistant
1004
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23520
MIDLANDS CHOICE
NE
01
—
91177983268510A015
TRICARE
NE
01
—
970023869
RAILROAD MEDICARE
NE
Enumeration date
02/17/2006
Last updated
07/27/2016
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