Individual
DR. SHIRLEY SHARP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-3258
(706) 721-8623
(706) 721-1459
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-8623
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
92490
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
92490
GA LICENSE
GA
Enumeration date
06/12/2014
Last updated
06/24/2022
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