1902808835 NPI number — SARITA SHARMA M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902808835 NPI number — SARITA SHARMA M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SHARMA

Provider First Name:

SARITA

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

F

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:

1902808835

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

10/18/2011

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

3100 WYMAN PARK DR

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

BALTIMORE

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

21211-2803

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

410-338-3500

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

12916 CONAMAR DR

Provider Second Line Business Practice Location Address:

SUITE 204

Provider Business Practice Location Address City Name:

HAGERSTOWN

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

21742-2760

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

301-685-3166

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

08/11/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207QG0300X , with the licence number:  043218 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207QG0300X , with the licence number: D0070877 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 010043218CT01 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
• Identifier: 061561581 . This is a "HEALTH CT" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
• Identifier: 1061762 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
• Identifier: 001432187 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
• Identifier: 061561581 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
• Identifier: 043218 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
• Identifier: 2V7005 . This is a "HEALTH NET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
• Identifier: 061561581 . This is a "CIGNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
• Identifier: 368744 . This is a "WELLCARE OF CT" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
• Identifier: D0070877 . This is a "MARYLAND MEDICAL BOARD PHYSICIANS LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: P3650512 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".