Provider Demographics
NPI:1578541017
Name:SHARMA, KULDIP (MD)
Entity Type:Individual
Prefix:DR
First Name:KULDIP
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 1:255 N BREIEL BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-3807
Mailing Address - Country:US
Mailing Address - Phone:513-422-5915
Mailing Address - Fax:513-422-5101
Practice Address - Street 1:255 N BREIEL BLVD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-3807
Practice Address - Country:US
Practice Address - Phone:513-422-5915
Practice Address - Fax:513-422-5101
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35059854S207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00010308OtherRRMC
OH000000232753OtherANTHEM
OH141120002OtherCARESOURCE
OH0835467Medicaid
OH0835467Medicaid
OHE80166Medicare UPIN