1700885712 NPI number — RAJIV K SHARMA M.D.

Table of content: RAJIV K SHARMA M.D. (NPI 1700885712)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700885712 NPI number — RAJIV K SHARMA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHARMA
Provider First Name:
RAJIV
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700885712
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 E MOREHEAD ST
Provider Second Line Business Mailing Address:
STE 300
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28202-2788
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-334-7800
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 E MOREHEAD ST
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28202-2788
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-334-7800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085P0229X , with the licence number:  9801055 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: DR.0069830 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 23120 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 9801055 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: N01050 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8911481 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: SC 300130039 . This is a "RR MEDICARE SC" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: NC 300130037 . This is a "RR MEDICARE NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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