Provider Demographics
NPI:1063463131
Name:MAKHIJA, SHARMILA (MD)
Entity Type:Individual
Prefix:
First Name:SHARMILA
Middle Name:
Last Name:MAKHIJA
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 1:550 S JACKSON ST
Mailing Address - Street 2:ACB/2ND FLOOR
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:529 S. JACKSON STREET 3RD FLOOR
Practice Address - Street 2:JAMES GRAHAM BROWN CANCER CENTER
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202
Practice Address - Country:US
Practice Address - Phone:502-561-7220
Practice Address - Fax:502-561-7327
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24337207VX0201X
KY29816207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009975190Medicaid
AL160054884OtherRAILROAD MEDICARE
AL051504895Medicaid
AL051504896OtherBLUE CROSS
AL051530408OtherBLUE CROSS
AL051504895OtherBLUE CROSS
AL009932914Medicaid
AL009969175Medicaid
AL051524138OtherBLUE CROSS
AL160054884OtherRAILROAD MEDICARE
AL051504896OtherBLUE CROSS
KYK016511Medicare PIN