Provider Demographics
NPI:1174634299
Name:SHARMA, GUMMULURU VRK (MD)
Entity Type:Individual
Prefix:DR
First Name:GUMMULURU
Middle Name:VRK
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SHARMA
Other - Middle Name:VRK
Other - Last Name:GUMMULURU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1400 VFW PKWY
Mailing Address - Street 2:DIVISION OF CARDIOLOGY
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-4927
Mailing Address - Country:US
Mailing Address - Phone:617-323-7700
Mailing Address - Fax:857-203-5550
Practice Address - Street 1:1400 VFW PKWY
Practice Address - Street 2:DIVISION OF CARDIOLOGY
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-4927
Practice Address - Country:US
Practice Address - Phone:617-323-7700
Practice Address - Fax:857-203-5550
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA35204207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease