Provider Demographics
NPI:1467475343
Name:OM SHARMA MD PC
Entity Type:Organization
Organization Name:OM SHARMA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-253-3551
Mailing Address - Street 1:2100 LEHIGH ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3830
Mailing Address - Country:US
Mailing Address - Phone:610-253-3551
Mailing Address - Fax:610-250-1043
Practice Address - Street 1:2100 LEHIGH ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3830
Practice Address - Country:US
Practice Address - Phone:610-253-3551
Practice Address - Fax:610-250-1043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037664L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1765887OtherHIGHMARK BLUE SHIELD
PA099073Medicare PIN