Provider Demographics
NPI:1679708077
Name:SHARMA, RACHANA (MD)
Entity Type:Individual
Prefix:
First Name:RACHANA
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:PO BOX 602658
Mailing Address - Street 2:WAKE FOREST UNIVERSITY HEALTH SCIENCES
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2658
Mailing Address - Country:US
Mailing Address - Phone:336-716-2255
Mailing Address - Fax:336-716-3202
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-2255
Practice Address - Fax:336-716-3202
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY42619207L00000X
NC2012-02319207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC9413414OtherAETNA
WV3810026071OtherWV MEDICAID
KY7100080670Medicaid
NC1679708077Medicaid
NC3122478OtherUNITED HEALTHCARE
VA1679708077OtherVIRGINIA MEDICAID
NC179TGOtherBCBS
IN200951830Medicaid
NC267251OtherMEDCOST
NC1679708077OtherTRICARE
SCQ02319OtherSC MEDICAID
WV3810026071OtherWV MEDICAID
IN200951830Medicaid