Provider Demographics
NPI:1497894638
Name:SHARMA, KEWAL K (MD)
Entity Type:Individual
Prefix:DR
First Name:KEWAL
Middle Name:K
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 1:9801 GEORGIA AVE
Mailing Address - Street 2:STE 342
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5276
Mailing Address - Country:US
Mailing Address - Phone:301-649-7080
Mailing Address - Fax:301-649-6532
Practice Address - Street 1:9801 GEORGIA AVE
Practice Address - Street 2:STE 342
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5276
Practice Address - Country:US
Practice Address - Phone:301-649-7018
Practice Address - Fax:301-593-9055
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0040804174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF44615Medicare UPIN