Provider Demographics
NPI:1235357971
Name:DESH P SHARMA MD
Entity Type:Organization
Organization Name:DESH P SHARMA MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DESH
Authorized Official - Middle Name:P
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-420-9844
Mailing Address - Street 1:602 S ATWOOD RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4172
Mailing Address - Country:US
Mailing Address - Phone:410-420-9844
Mailing Address - Fax:410-420-9846
Practice Address - Street 1:602 S ATWOOD RD
Practice Address - Street 2:SUITE 106
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4172
Practice Address - Country:US
Practice Address - Phone:410-420-9844
Practice Address - Fax:410-420-9846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD31856207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
8961Medicare ID - Type Unspecified