Provider Demographics
NPI:1558437731
Name:SABESAN, SHARDHA K (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARDHA
Middle Name:K
Last Name:SABESAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHARDHA
Other - Middle Name:
Other - Last Name:KUPPUSWAMY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4606 CENTRAL TER
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-1741
Mailing Address - Country:US
Mailing Address - Phone:302-355-0683
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-3902
Practice Address - Country:US
Practice Address - Phone:610-874-5257
Practice Address - Fax:610-874-7241
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4301172084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry