Provider Demographics
NPI:1619921822
Name:SHARMA, BHAVNA (MD)
Entity Type:Individual
Prefix:
First Name:BHAVNA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 ESSEX CT
Mailing Address - Street 2:SUITE C
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-3160
Mailing Address - Country:US
Mailing Address - Phone:256-325-8457
Mailing Address - Fax:256-325-8454
Practice Address - Street 1:12205 COUNTY LINE RD STE B
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-7720
Practice Address - Country:US
Practice Address - Phone:256-325-8457
Practice Address - Fax:256-325-8454
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00026846207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51001371OtherBLUE CROSS BLUE SHIELD
AL3003OtherNEIC SITE ID NUMBER
AL009932627Medicaid
AL009932627Medicaid
AL009932627Medicaid
AL102I088297Medicare PIN