Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 10062 | SC |
NPI | 1013023340 |
---|---|
Provider Name | Kenneth A Sharpe |
First Address | Charlotte, NC 28263-0001 |
Second Address | Charleston, SC 29414-5896 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 13/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100624 | (05) | SC |
B97691 | (02) | SC |