Provider Demographics
NPI:1043239650
Name:SHARPE, TIMOTHY LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:LOUIS
Last Name:SHARPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:309 SEASIDE AVE
Mailing Address - Street 2:SUITE 203-204
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4625
Mailing Address - Country:US
Mailing Address - Phone:203-882-9100
Mailing Address - Fax:203-882-8997
Practice Address - Street 1:309 SEASIDE AVE
Practice Address - Street 2:SUITE 203-204
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460
Practice Address - Country:US
Practice Address - Phone:203-882-9100
Practice Address - Fax:203-882-8997
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT22650207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB84571Medicare UPIN