Provider Demographics
NPI:1093533986
Name:SHARP, LOGAN JAMES I
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:JAMES
Last Name:SHARP
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6110 WHITEACRE RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-1033
Mailing Address - Country:US
Mailing Address - Phone:567-666-8749
Mailing Address - Fax:
Practice Address - Street 1:6110 WHITEACRE RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1033
Practice Address - Country:US
Practice Address - Phone:567-666-8749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide