Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | MD024070E | PA |
NPI | 1164421723 |
---|---|
Provider Name | Ira Robert Sharp |
First Address | Huntingdon Valley, PA 19006-2119 |
Second Address | Jenkintown, PA 19046-3200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2005 |
Last Update Date | 24/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B30258 | (02) | PA |