Provider Demographics
NPI:1780652230
Name:SHARP, DONALD A (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:A
Last Name:SHARP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 OAK RIDGE TPKE
Mailing Address - Street 2:SUITE A300
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6957
Mailing Address - Country:US
Mailing Address - Phone:865-482-2129
Mailing Address - Fax:865-482-4036
Practice Address - Street 1:800 OAK RIDGE TPKE
Practice Address - Street 2:SUITE A300
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6957
Practice Address - Country:US
Practice Address - Phone:865-482-2129
Practice Address - Fax:865-482-4036
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000009101174400000X
TNMD9101207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
621230317OtherTAX ID
070000466OtherRAILROAD MEDICARE
2007072OtherBLUECROSS OF TENNESSEE ID
621230317OtherTAX ID
TNB04720Medicare UPIN
TN3196713Medicare PIN