Basic Information
| Provider Information | |||||||||
| NPI: | 1609086685 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHARP | ||||||||
| FirstName: | WHITNEY | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7740 WASHINGTON VILLAGE DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454593994 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374334325 | ||||||||
| FaxNumber: | 9374397445 | ||||||||
| Practice Location | |||||||||
| Address1: | 7740 WASHINGTON VILLAGE DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454593994 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374334325 | ||||||||
| FaxNumber: | 9374397445 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2007 | ||||||||
| LastUpdateDate: | 11/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 34009638 | OH | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 2982223 | 05 | OH | MEDICAID |