Provider Demographics
NPI:1447206743
Name:SHARMA, SANDEEP B (MD)
Entity Type:Individual
Prefix:
First Name:SANDEEP
Middle Name:B
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6109 CHRISTOPHER WREN DR
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7364
Mailing Address - Country:US
Mailing Address - Phone:412-512-4139
Mailing Address - Fax:
Practice Address - Street 1:128 N CRAIG ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2744
Practice Address - Country:US
Practice Address - Phone:856-210-0188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417491207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA716920OtherUPMC
PA001881239OtherPA BCBS
PA7901898OtherAETNA
PA1016630380001Medicaid
PA1555037OtherGATEWAY
PAPOO343046OtherRR MEDICARE
PA187194OtherUNISON
WV3810009328Medicaid
PA1555037OtherGATEWAY