Provider Demographics
NPI:1225193493
Name:SHARMA, MALVIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:MALVIKA
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 1:9899 MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-2064
Mailing Address - Country:US
Mailing Address - Phone:301-414-0023
Mailing Address - Fax:301-414-0186
Practice Address - Street 1:9899 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DAMASCUS
Practice Address - State:MD
Practice Address - Zip Code:20872-2064
Practice Address - Country:US
Practice Address - Phone:301-414-0023
Practice Address - Fax:301-414-0186
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0050849208000000X
DCMD30742208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
011381M92Medicare ID - Type Unspecified
H81842Medicare UPIN