Provider Demographics
NPI:1093724908
Name:RAMPRASAD, SHARMILA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARMILA
Middle Name:
Last Name:RAMPRASAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3104 CREEKSIDE VILLAGE DR NW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-2324
Mailing Address - Country:US
Mailing Address - Phone:770-627-3986
Mailing Address - Fax:770-872-0517
Practice Address - Street 1:3104 CREEKSIDE VILLAGE DR NW
Practice Address - Street 2:SUITE 201
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-2324
Practice Address - Country:US
Practice Address - Phone:770-627-3986
Practice Address - Fax:770-872-0517
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA57482207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA581884156CMedicaid