Provider Demographics
NPI:1083997860
Name:SHARMA, MANISHA A (MD)
Entity Type:Individual
Prefix:DR
First Name:MANISHA
Middle Name:A
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1169 JEFFERSON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-7217
Mailing Address - Country:US
Mailing Address - Phone:443-451-4993
Mailing Address - Fax:443-438-3446
Practice Address - Street 1:733 W 40TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2112
Practice Address - Country:US
Practice Address - Phone:443-451-4993
Practice Address - Fax:443-438-3446
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2019-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY271866207Q00000X
DCMD041537207Q00000X
TN55009207Q00000X
KS04-41364207Q00000X
GA082054207Q00000X
OH35.135376207Q00000X
FLME139213207Q00000X
DEC1-0013097207Q00000X
CAC156518207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD071727400Medicaid
MD358288YVZMedicare PIN
MD358287YWV2Medicare PIN
MD358288ZDDBMedicare PIN