Provider Demographics
NPI:1114965902
Name:SHARMA, MUKESH K (MD)
Entity Type:Individual
Prefix:DR
First Name:MUKESH
Middle Name:K
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10810 PARKSIDE DR STE 206
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1981
Mailing Address - Country:US
Mailing Address - Phone:865-672-4500
Mailing Address - Fax:865-672-4509
Practice Address - Street 1:10810 PARKSIDE DR STE 206
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1981
Practice Address - Country:US
Practice Address - Phone:865-672-4500
Practice Address - Fax:865-672-4509
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD24505207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ003266Medicaid
E28932Medicare UPIN
TN103I061112Medicare PIN
TN3075877Medicare PIN