Doctor Name: | RUSSELL A SHARPLESS |
NPI Number: | 1134101181 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | MA001857L |
Business Practice Address: | 814 Washington St Huntingdon, PA - 166521726 |
Business Phone Number: | 8146434415 |
Business Fax Number: | 8146432620 |
Mailing Address: | 814 Washington St, HUNTINGDON |
State: | PA |
Postal Code: | 166521726 |
Phone Number: | 8146434415 |
Fax Number: | 8146432620 |
NPI Enumeration Date: | 11/16/2005 |
NPI Last Update Date: | 06/02/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | MA001857L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |