Provider Demographics
NPI:1033129234
Name:SHARAN, KANU P (MD)
Entity Type:Individual
Prefix:
First Name:KANU
Middle Name:P
Last Name:SHARAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:2 COOPER PLZ
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103
Practice Address - Country:US
Practice Address - Phone:855-632-2667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA080563207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2761528000OtherAMERIHEALTH, KEYSTONE, IBC
43886OtherUNIVERSITY HEALTHPLAN
PA1891985OtherPENSYVANIA BLUE SHIELD
1340402OtherAETNA
P00376176OtherRR MEDICARE
60026412OtherHORIZON NJ HEALTH
NJ0114189Medicaid
1178995OtherCIGNA
2736090OtherUNITED HEALTHCARE
3K5929OtherHEALTHNET
P3722720OtherOXFORD
NJ103820 PXAMedicare PIN