Provider Demographics
NPI:1447397310
Name:SHARMA, PALLAVI (MD)
Entity Type:Individual
Prefix:
First Name:PALLAVI
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:150 MEDICAL WAY
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-2533
Mailing Address - Country:US
Mailing Address - Phone:770-991-1600
Mailing Address - Fax:770-991-1616
Practice Address - Street 1:1002 HOSPITAL DR
Practice Address - Street 2:BLDG-B
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7384
Practice Address - Country:US
Practice Address - Phone:678-565-7155
Practice Address - Fax:678-565-7455
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2012-09-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA056221207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA66BBBHQMedicare ID - Type UnspecifiedPROVIDER NUMBER
GA511I660006Medicare PIN
GAG78083Medicare UPIN