1811562994 NPI number — DR. AKHYA SHARMA MBBS

Table of content: DR. AKHYA SHARMA MBBS (NPI 1811562994)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811562994 NPI number — DR. AKHYA SHARMA MBBS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHARMA
Provider First Name:
AKHYA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MBBS
Provider Gender Code:
F

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:
1811562994
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3249 SOUTH OAK PARK AVE, LOYOLA MEDICINE MACNEAL HOSPI
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BERWYN
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-783-3401
Provider Business Mailing Address Fax Number:
804-828-0489

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 HOSPITAL DRIVE,
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
60521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-882-0808
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/21/2021

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 2024014188 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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