Individual
PHILIP MARION SHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
214 E 23RD ST, CHEYENNE, WY 82001-3748
(307) 633-6080
(307) 432-3106
Mailing address
PO BOX 20970, CHEYENNE, WY 82003-7020
(307) 773-8012
(307) 633-7676
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
2371A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102341100
—
WY
01
—
2371A
STATE LICENSE
WY
01
—
430PS98
SUBSTANCE CONTROL
WY
Enumeration date
11/23/2005
Last updated
10/23/2013
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