Provider Demographics
NPI:1194769679
Name:SHARP, CARL E (DPM)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:E
Last Name:SHARP
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 E WILSON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2301
Mailing Address - Country:US
Mailing Address - Phone:614-885-8895
Mailing Address - Fax:614-785-6543
Practice Address - Street 1:37 E WILSON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2301
Practice Address - Country:US
Practice Address - Phone:614-885-8895
Practice Address - Fax:614-785-6543
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36001718S213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2700517OtherUNITED HEALTH CARE
OH1752OtherNATIONWIDE
OHP00154532OtherRAILROAD MEDICARE
OH0301864Medicaid
OH000000339079OtherANTHEM
OH4015783OtherAETNA
OH091504000008OtherCENTRAL BENEFITS
OH760725667028OtherCARESOURCE
OH1752OtherNATIONWIDE
OH2700517OtherUNITED HEALTH CARE
OH5202200001Medicare NSC