Provider Demographics
NPI:1114214459
Name:SHARMA, MANU (MD)
Entity Type:Individual
Prefix:DR
First Name:MANU
Middle Name:
Last Name:SHARMA
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 1:3301 QUARRY DRIVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303
Mailing Address - Country:US
Mailing Address - Phone:646-318-4992
Mailing Address - Fax:
Practice Address - Street 1:3436 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-1834
Practice Address - Country:US
Practice Address - Phone:910-426-7337
Practice Address - Fax:910-424-1418
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-01109208000000X
NC201101109208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1114214459OtherHEALTHSMART
NC1114214459Medicaid
NC4015451OtherCOVENTRY NATIONAL - COVENTRY PPO
NC9777745OtherAETNA
NC1114214459OtherHUMANA
NC1305465OtherCOVENTRY OF THE CAROLINAS
NC1305465Other1ST HEALTH
NC4015451OtherGEHA/MAILHANDLERS
NC1114214459OtherHEALTHNET FEDERAL SERVICES
NC13037216OtherPHCS-MULTIPLAN
NC1965107OtherCIGNA-GREATWEST
NC167VJOtherBCBS OF NC
NC1305465OtherWELLPATH
NC237960OtherMEDCOST
NC3369235OtherUNITED HEALTHCARE
NCFH1101535OtherFIRST CAROLINA CARE