Provider Demographics
NPI:1578511028
Name:SHARMA, ANJMUN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANJMUN
Middle Name:
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 1:9820 PALISADE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1490
Mailing Address - Country:US
Mailing Address - Phone:719-313-8401
Mailing Address - Fax:888-390-1539
Practice Address - Street 1:1150 W BAPTIST RD STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-2480
Practice Address - Country:US
Practice Address - Phone:719-445-9852
Practice Address - Fax:719-426-9796
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46192207P00000X, 207Q00000X
OH35086983207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOAAA0136Medicare UPIN
OHI50477Medicare UPIN