Provider Demographics
NPI:1619155181
Name:LOTT, NAGMA SHARMA (MD)
Entity Type:Individual
Prefix:
First Name:NAGMA
Middle Name:SHARMA
Last Name:LOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NAGMA
Other - Middle Name:SHARMA
Other - Last Name:SHAHRYAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5112 W OLIVE AVE STE C-113
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-4209
Mailing Address - Country:US
Mailing Address - Phone:623-939-8618
Mailing Address - Fax:623-939-9184
Practice Address - Street 1:5112 W OLIVE AVE STE C-113
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-4209
Practice Address - Country:US
Practice Address - Phone:623-939-8618
Practice Address - Fax:623-939-9184
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2019-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000956207QG0300X
AZ53551207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine