Provider Demographics
NPI:1528026093
Name:SHARMA, AJEET L (MD)
Entity Type:Individual
Prefix:DR
First Name:AJEET
Middle Name:L
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 BAY PARK DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-4921
Mailing Address - Country:US
Mailing Address - Phone:419-725-6801
Mailing Address - Fax:419-725-6803
Practice Address - Street 1:2751 BAY PARK DR
Practice Address - Street 2:SUITE 204
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-4921
Practice Address - Country:US
Practice Address - Phone:419-725-6801
Practice Address - Fax:419-725-6803
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077414207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000360612OtherANTHEM
OH2205910Medicaid
OHP00179446OtherMEDICARE RAILROAD
OH2205910Medicaid
OH4036054Medicare PIN