Provider Demographics
NPI:1275621674
Name:SHARMA, SUSMEETA TEWARI (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSMEETA
Middle Name:TEWARI
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUSMEETA
Other - Middle Name:
Other - Last Name:TEWARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 IRVING ST NW
Mailing Address - Street 2:SUITE 2A-72
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:202-877-6563
Mailing Address - Fax:202-877-6588
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:SUITE 2A-72
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-6563
Practice Address - Fax:202-877-6588
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN10067207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRES000Medicare UPIN