Provider Demographics
NPI:1699743385
Name:SHARP, MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:SHARP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8015 BARDSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-3439
Mailing Address - Country:US
Mailing Address - Phone:502-239-3993
Mailing Address - Fax:502-239-3939
Practice Address - Street 1:8015 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-3439
Practice Address - Country:US
Practice Address - Phone:502-239-3993
Practice Address - Fax:502-239-3939
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000311892OtherANTHEM
KY50003459Medicaid
KYU68234Medicare UPIN
KY50003459Medicaid