Provider Demographics
NPI:1285784439
Name:SHARPE, TERRY LYNN (MD, PC)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:LYNN
Last Name:SHARPE
Suffix:
Gender:F
Credentials:MD, PC
Other - Prefix:
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Mailing Address - Street 1:110 WALTER WAY UNIT 98
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-9500
Mailing Address - Country:US
Mailing Address - Phone:770-507-8481
Mailing Address - Fax:770-507-5358
Practice Address - Street 1:110 WALTER WAY UNIT 98
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9500
Practice Address - Country:US
Practice Address - Phone:770-507-8481
Practice Address - Fax:770-507-5358
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA025826207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000303806CMedicaid
GAD41093Medicare UPIN