Provider Demographics
NPI:1508900549
Name:SHARMA, ROHIT (OD)
Entity Type:Individual
Prefix:
First Name:ROHIT
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3071 CAMPBELLTON RD SW
Mailing Address - Street 2:SUITE #1
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-5441
Mailing Address - Country:US
Mailing Address - Phone:404-344-3556
Mailing Address - Fax:404-344-3500
Practice Address - Street 1:3071 CAMPBELLTON RD SW
Practice Address - Street 2:SUITE #1
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-5441
Practice Address - Country:US
Practice Address - Phone:404-344-3556
Practice Address - Fax:404-344-3500
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002164152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA814363756AMedicaid
GA1508900549OtherNPI
GAP00692413OtherRAILROAD MEDICARE PTAN
GA814363756AMedicaid