Provider Demographics
NPI:1548824394
Name:SHARP, MATTHEW GARY (DO)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:GARY
Last Name:SHARP
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1343 LIGHTHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-6830
Mailing Address - Country:US
Mailing Address - Phone:208-390-2690
Mailing Address - Fax:
Practice Address - Street 1:131 MILLER ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2508
Practice Address - Country:US
Practice Address - Phone:336-716-8200
Practice Address - Fax:336-716-9841
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2023-005192081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine