Individual
SHASTINE M SHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
825 BARRET AVE, LOUISVILLE, KY 40204-1743
(931) 245-8600
(931) 245-8660
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47825
KY
207Q00000X
Family Medicine Physician
50146
TN
207Q00000X
Family Medicine Physician
MT197438
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1532928
—
TN
05
—
7100650020
—
KY
Enumeration date
07/16/2010
Last updated
05/01/2025
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