Provider Demographics
NPI:1477725877
Name:SHARMA, SUBHASHINI PEDDIREDDI (PT)
Entity Type:Individual
Prefix:MRS
First Name:SUBHASHINI
Middle Name:PEDDIREDDI
Last Name:SHARMA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SUBHASHINI
Other - Middle Name:
Other - Last Name:REDDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8300 HEALTH PARK STE 127
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4731
Mailing Address - Country:US
Mailing Address - Phone:919-845-6160
Mailing Address - Fax:919-845-6188
Practice Address - Street 1:3700 NW CARY PKWY STE 110
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8446
Practice Address - Country:US
Practice Address - Phone:919-319-3649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC114292251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7212423Medicaid
NC7212423Medicaid