Provider Demographics
NPI:1689659229
Name:SHARMA, VIBHA (MD)
Entity Type:Individual
Prefix:DR
First Name:VIBHA
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 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:157 UNION ST
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1228
Practice Address - Country:US
Practice Address - Phone:508-481-0080
Practice Address - Fax:508-486-5708
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222631174400000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA24610OtherHARVARD PILGRIM HEALTH CA
MA201846974OtherFEDERAL TAX ID
MA467768OtherTUFTS HEALTH PLAN
MA110039893Medicaid
MAJ28380OtherBLUE CROSS BLUE SHIELD
MA92990OtherFALLON COMMUNITY HEALTH P
MA467768OtherTUFTS HEALTH PLAN
MA110039893Medicaid