Provider Demographics
NPI:1447224068
Name:CHATTERJEE, SHARMILA (MD, MPH)
Entity Type:Individual
Prefix:
First Name:SHARMILA
Middle Name:
Last Name:CHATTERJEE
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1800 HARRISON ST FL 7
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3466
Mailing Address - Country:US
Mailing Address - Phone:510-625-2856
Mailing Address - Fax:877-738-4262
Practice Address - Street 1:568 N SUNRISE AVE
Practice Address - Street 2:STE 250
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3097
Practice Address - Country:US
Practice Address - Phone:916-865-1140
Practice Address - Fax:916-865-1145
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA205713207Q00000X
CAA54652207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2100541Medicaid
MAG89154Medicare UPIN
MAA38374Medicare ID - Type Unspecified