Individual
DR. BRETT WALLACE SHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1277 E 100 S, LOGAN, UT 84321-4974
(757) 995-5118
Mailing address
1277 E 100 S, LOGAN, UT 84321-4974
(757) 995-5118
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
0101-240151
VA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
182472-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010297222
—
VA
Enumeration date
07/21/2006
Last updated
03/07/2023
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